British Columbia Committee Hansard (Blues) — 24 July 2020, p.m., Issue 16 (41st Parliament, 5th Session) (20200724pm CommitteeC n16)

20200724pm CommitteeC n16

British Columbia — Debates (Hansard)

Fifth Session, 41st Parliament REPORT OF PROCEEDINGS (HANSARD) COMMITTEE OF SUPPLY ,

SECTION C Virtual Meeting Friday, July 24, 2020 Afternoon Meeting Issue No. 16 Presiding Officers: RAJ CHOUHAN, DEPUTY SPEAKER SPENCER CHANDRA HERBERT, DEPUTY CHAIR, COMMITTEE OF THE WHOLE ISSN 2563-352X

PROVINCE OF BRITISH COLUMBIA (Entered Confederation July 20, 1871) LIEUTENANT-GOVERNOR Her Honour the Honourable Janet Austin, OBC Fifth Session, 41st Parliament SPEAKER OF THE LEGISLATIVE ASSEMBLY Honourable Darryl Plecas EXECUTIVE COUNCIL Premier and President of the Executive Council ............................................................................................................... Hon. John Horgan Deputy Premier and Minister of Finance............................................................................................................................Hon.

Carole James Minister of Advanced Education, Skills and Training..................................................................................................... Hon. Melanie Mark Minister of Agriculture.........................................................................................................................................................Hon. Lana Popham Attorney General.................................................................................................................................................................Hon.

David Eby, QC Minister of Children and Family Development ............................................................................................................ Hon. Katrine Conroy Minister of State for Child Care...................................................................................................................................... Hon. Katrina Chen Minister of Citizens’ Services...................................................................................................................................................Hon.

Anne Kang Minister of Education ............................................................................................................................................................ Hon. Rob Fleming Minister of Energy, Mines and Petroleum Resources ..................................................................................................... Hon. Bruce Ralston Minister of Environment and Climate Change Strategy............................................................................................. Hon.

George Heyman Minister of Forests, Lands, Natural Resource Operations and Rural Development ..............................................Hon. Doug Donaldson Minister of Health .....................................................................................................................................................................Hon. Adrian Dix Minister of Indigenous Relations and Reconciliation ......................................................................................................... Hon.

Scott Fraser Minister of Jobs, Economic Development and Competitiveness.............................................................................Hon. Michelle Mungall Minister of State for Trade...............................................................................................................................................Hon. George Chow Minister of Labour ...................................................................................................................................................................Hon.

Harry Bains Minister of Mental Health and Addictions............................................................................................................................ Hon. Judy Darcy Minister of Municipal Affairs and Housing.................................................................................................................. Hon. Selina Robinson Minister of Public Safety and Solicitor General ........................................................................................................... Hon.

Mike Farnworth Minister of Social Development and Poverty Reduction..............................................................................................Hon. Shane Simpson Minister of Tourism, Arts and Culture.....................................................................................................................................Hon. Lisa Beare Minister of Transportation and Infrastructure................................................................................................................ Hon.

Claire Trevena LEGISLATIVE ASSEMBLY Leader of the Official Opposition................................................................................................................................Andrew Wilkinson, QC Leader of the Third Party .................................................................................................................................................................Adam Olsen Deputy Speaker................................................................................................................................................................................

Raj Chouhan Assistant Deputy Speaker............................................................................................................................................................. Simon Gibson Deputy Chair, Committee of the Whole ................................................................................................................ Spencer Chandra Herbert Clerk of the Legislative Assembly ...........................................................................................................................................

Kate Ryan-Lloyd Law Clerk and Parliamentary Counsel.............................................................................................................................. Seunghee Suzie Seo Clerk Assistant, Parliamentary Services...........................................................................................................................

Artour Sogomonian Clerk Assistant, Committees and Interparliamentary Relations ..............................................................................................Susan Sourial Senior Research Analyst ................................................................................................................................................................. Jennifer Arril Senior Research Analyst ...................................................................................................................................................................

Karan Riarh Acting Sergeant-at-Arms..................................................................................................................................................................Greg Nelson

ALPHABETICAL LIST OF MEMBERS Ashton, Dan (BC Liberal) ......................................................................... Penticton Bains, Hon. Harry (NDP)................................................................ Surrey-Newton Barnett, Donna (BC Liberal) .....................................................Cariboo-Chilcotin Beare, Hon. Lisa (NDP)..............................................

Maple Ridge–Pitt Meadows Begg, Garry (NDP) .......................................................................Surrey-Guildford Bernier, Mike (BC Liberal) .........................................................Peace River South Bond, Shirley (BC Liberal)...........................................Prince George–Valemount Brar, Jagrup (NDP).......................................................................Surrey-Fleetwood Cadieux, Stephanie (BC Liberal)........................................................

Surrey South Chandra Herbert, Spencer (NDP) .......................................Vancouver–West End Chen, Hon. Katrina (NDP)...................................................... Burnaby-Lougheed Chouhan, Raj (NDP) .................................................................Burnaby-Edmonds Chow, Hon. George (NDP).................................................Vancouver-Fraserview Clovechok, Doug (BC Liberal) ..................................Columbia River–Revelstoke Coleman, Rich (BC Liberal) ................................................................ Langley East Conroy, Hon.

Katrine (NDP)...........................................................Kootenay West Darcy, Hon. Judy (NDP) ............................................................. New Westminster Davies, Dan (BC Liberal) ........................................................... Peace River North de Jong, Michael, QC (BC Liberal) ..............................................Abbotsford West Dean, Mitzi (NDP)................................................................ Esquimalt-Metchosin D’Eith, Bob (NDP) ................................................................Maple Ridge–Mission Dix, Hon.

Adrian (NDP)....................................................... Vancouver-Kingsway Donaldson, Hon. Doug (NDP)...................................................................... Stikine Eby, Hon. David, QC (NDP).............................................. Vancouver–Point Grey Elmore, Mable (NDP).........................................................Vancouver-Kensington Farnworth, Hon. Mike (NDP) ........................................................Port Coquitlam Fleming, Hon. Rob (NDP) ......................................................

Victoria–Swan Lake Foster, Eric (BC Liberal).............................................................Vernon-Monashee Fraser, Hon. Scott (NDP) ..................................................Mid Island–Pacific Rim Furstenau, Sonia (BC Green Party) .............................................Cowichan Valley Gibson, Simon (BC Liberal) ...................................................Abbotsford-Mission Glumac, Rick (NDP).........................................................Port Moody–Coquitlam Heyman, Hon. George (NDP) ................................................Vancouver-Fairview Horgan, Hon.

John (NDP) ................................................ Langford–Juan de Fuca Hunt, Marvin (BC Liberal) ........................................................ Surrey-Cloverdale Isaacs, Joan (BC Liberal) .......................................... Coquitlam–Burke Mountain James, Hon. Carole (NDP).................................................... Victoria–Beacon Hill Johal, Jas (BC Liberal).................................................Richmond-Queensborough Kahlon, Ravi (NDP)............................................................................... Delta North Kang, Hon.

Anne (NDP)......................................................... Burnaby–Deer Lake Kyllo, Greg (BC Liberal)..............................................................................Shuswap Larson, Linda (BC Liberal) .............................................. Boundary-Similkameen Lee, Michael (BC Liberal) ........................................................Vancouver-Langara Leonard, Ronna-Rae (NDP) ..................................................... Courtenay-Comox Letnick, Norm (BC Liberal).............................................

Kelowna–Lake Country Ma, Bowinn (NDP) .....................................................North Vancouver–Lonsdale Malcolmson, Sheila (NDP) ........................................................................Nanaimo Mark, Hon. Melanie (NDP) .......................................Vancouver–Mount Pleasant Martin, John (BC Liberal)....................................................................... Chilliwack Milobar, Peter (BC Liberal)..................................... Kamloops–North Thompson Morris, Mike (BC Liberal) ........................................... Prince George–Mackenzie Mungall, Hon.

Michelle (NDP)......................................................Nelson-Creston Oakes, Coralee (BC Liberal) ............................................................ Cariboo North Olsen, Adam (BC Green Party)............................ Saanich North and the Islands Paton, Ian (BC Liberal).......................................................................... Delta South Plecas, Hon. Darryl (Ind.) ........................................................... Abbotsford South Polak, Mary (BC Liberal) ............................................................................. Langley Popham, Hon.

Lana (NDP)............................................................... Saanich South Ralston, Hon. Bruce (NDP) ............................................................Surrey-Whalley Redies, Tracy (BC Liberal) .......................................................Surrey–White Rock Reid, Linda (BC Liberal) ................................................. Richmond South Centre Rice, Jennifer (NDP) ............................................................................. North Coast Robinson, Hon.

Selina (NDP) .........................................Coquitlam-Maillardville Ross, Ellis (BC Liberal)................................................................................... Skeena Routledge, Janet (NDP) ....................................................................Burnaby North Routley, Doug (NDP) ................................................. Nanaimo–North Cowichan Rustad, John (BC Liberal) ................................................................Nechako Lakes Shypitka, Tom (BC Liberal) ..............................................................

Kootenay East Simons, Nicholas (NDP) ......................................... Powell River–Sunshine Coast Simpson, Hon. Shane (NDP)..................................................Vancouver-Hastings Sims, Jinny (NDP) ........................................................................ Surrey-Panorama Singh, Rachna (NDP) .........................................................Surrey–Green Timbers Stewart, Ben (BC Liberal) ................................................................. Kelowna West Stilwell, Michelle (BC Liberal)...............................................

Parksville-Qualicum Stone, Todd (BC Liberal)..........................................Kamloops–South Thompson Sturdy, Jordan (BC Liberal)........................................ West Vancouver–Sea to Sky Sullivan, Sam (BC Liberal)................................................ Vancouver–False Creek Sultan, Ralph (BC Liberal) ...........................................West Vancouver–Capilano Tegart, Jackie (BC Liberal) ................................................................. Fraser-Nicola Thomson, Steve (BC Liberal)......................................................

Kelowna-Mission Thornthwaite, Jane (BC Liberal) ...............................North Vancouver–Seymour Throness, Laurie (BC Liberal) .......................................................Chilliwack-Kent Trevena, Hon. Claire (NDP) ................................................................North Island Wat, Teresa (BC Liberal) ................................................. Richmond North Centre Weaver, Dr.

Andrew (Ind.)................................................Oak Bay–Gordon Head Wilkinson, Andrew, QC (BC Liberal) ................................Vancouver-Quilchena Y ap, John (BC Liberal)............................................................Richmond-Steveston LIST OF MEMBERS BY RIDING Abbotsford-Mission............................................................................Simon Gibson Abbotsford South....................................................................... Hon. Darryl Plecas Abbotsford West......................................................................

Michael de Jong, QC Boundary-Similkameen...................................................................... Linda Larson Burnaby–Deer Lake....................................................................... Hon. Anne Kang Burnaby-Edmonds................................................................................Raj Chouhan Burnaby-Lougheed .................................................................... Hon. Katrina Chen Burnaby North .................................................................................

Janet Routledge Cariboo-Chilcotin .............................................................................Donna Barnett Cariboo North.................................................................................... Coralee Oakes Chilliwack ............................................................................................... John Martin Chilliwack-Kent ...............................................................................Laurie Throness Columbia River–Revelstoke .........................................................

Doug Clovechok Coquitlam–Burke Mountain.................................................................. Joan Isaacs Coquitlam-Maillardville ...................................................... Hon. Selina Robinson Courtenay-Comox................................................................... Ronna-Rae Leonard Cowichan Valley .............................................................................

Sonia Furstenau Delta North.............................................................................................Ravi Kahlon Delta South ..................................................................................................Ian Paton Esquimalt-Metchosin ..............................................................................Mitzi Dean Fraser-Nicola .........................................................................................

Jackie Tegart Kamloops–North Thompson .............................................................Peter Milobar Kamloops–South Thompson..................................................................Todd Stone Kelowna–Lake Country .....................................................................Norm Letnick Kelowna-Mission ..............................................................................

Steve Thomson Kelowna West ..........................................................................................Ben Stewart Kootenay East.......................................................................................Tom Shypitka Kootenay West........................................................................ Hon. Katrine Conroy Langford–Juan de Fuca .............................................................. Hon. John Horgan Langley .....................................................................................................

Mary Polak Langley East.........................................................................................Rich Coleman Maple Ridge–Mission.............................................................................. Bob D’Eith Maple Ridge–Pitt Meadows............................................................Hon. Lisa Beare Mid Island–Pacific Rim................................................................ Hon. Scott Fraser Nanaimo......................................................................................

Sheila Malcolmson Nanaimo–North Cowichan............................................................... Doug Routley Nechako Lakes........................................................................................ John Rustad Nelson-Creston ................................................................... Hon. Michelle Mungall New Westminster........................................................................... Hon. Judy Darcy North Coast ...........................................................................................

Jennifer Rice North Island.............................................................................. Hon. Claire Trevena North Vancouver–Lonsdale................................................................... Bowinn Ma North Vancouver–Seymour........................................................Jane Thornthwaite Oak Bay–Gordon Head............................................................Dr.

Andrew Weaver Parksville-Qualicum.......................................................................Michelle Stilwell Peace River North ................................................................................... Dan Davies Peace River South ................................................................................ Mike Bernier Penticton ................................................................................................. Dan Ashton Port Coquitlam...................................................................... Hon.

Mike Farnworth Port Moody–Coquitlam.......................................................................Rick Glumac Powell River–Sunshine Coast....................................................... Nicholas Simons Prince George–Mackenzie....................................................................Mike Morris Prince George–Valemount ..................................................................

Shirley Bond Richmond North Centre..........................................................................Teresa Wat Richmond-Queensborough.........................................................................Jas Johal Richmond South Centre ......................................................................... Linda Reid Richmond-Steveston ...................................................................................

John Y ap Saanich North and the Islands .............................................................Adam Olsen Saanich South .............................................................................Hon. Lana Popham Shuswap...................................................................................................... Greg Kyllo Skeena........................................................................................................... Ellis Ross Stikine....................................................................................Hon.

Doug Donaldson Surrey-Cloverdale ................................................................................ Marvin Hunt Surrey-Fleetwood.....................................................................................Jagrup Brar Surrey–Green Timbers........................................................................Rachna Singh Surrey-Guildford......................................................................................Garry Begg Surrey-Newton ..............................................................................Hon.

Harry Bains Surrey-Panorama ...................................................................................... Jinny Sims Surrey South ................................................................................ Stephanie Cadieux Surrey-Whalley ......................................................................... Hon. Bruce Ralston Surrey–White Rock .............................................................................. Tracy Redies Vancouver-Fairview.............................................................. Hon.

George Heyman Vancouver–False Creek........................................................................ Sam Sullivan Vancouver-Fraserview...............................................................Hon. George Chow Vancouver-Hastings ............................................................... Hon. Shane Simpson Vancouver-Kensington....................................................................... Mable Elmore Vancouver-Kingsway..................................................................... Hon.

Adrian Dix Vancouver-Langara................................................................................ Michael Lee Vancouver–Mount Pleasant..................................................... Hon. Melanie Mark Vancouver–Point Grey ............................................................Hon.

David Eby, QC Vancouver-Quilchena........................................................Andrew Wilkinson, QC Vancouver–West End .....................................................Spencer Chandra Herbert Vernon-Monashee ....................................................................................Eric Foster Victoria–Beacon Hill.................................................................. Hon. Carole James Victoria–Swan Lake.................................................................... Hon. Rob Fleming West Vancouver–Capilano...................................................................

Ralph Sultan West Vancouver–Sea to Sky................................................................Jordan Sturdy Party Standings: BC Liberal 42; NDP 41; Independent 2; BC Green Party 2

CONTENTS Friday, July 24, 2020 Afternoon Meeting Page Committee of Supply Proceedings in

Section C.......................................................................................................................................................... 317 Estimates: Ministry of Health(continued) Hon. A. Dix M. Lee C. Oakes D. Ashton D. Davies D. Barnett D. Clovechok E. Ross J. Thornthwaite J. Isaacs J. Rustad J. Y ap L. Throness L. Larson M. Bernier M. Morris M. Stilwell R. Sultan S. Sullivan S. Bond T. Wat B. Stewart A. Olsen S. Furstenau L. Reid N. Letnick

FRIDAY , JULY 24, 2020 The committee met at 1:31 p.m. [S. Malcolmson in the chair.] Committee of Supply Proceedings in

Section C ESTIMATES: MINISTRY OF HEALTH (continued) On Vote 31: ministry operations, $22,042,385,000 (continued). The Chair:Good afternoon, Members. I call the Com- mittee of Supply,

Section C, to order. I want to recognize that I am in the B.C. Legislature, meeting from the homeland of theLək̓ ʷəŋin̓ əŋ-speaking people, Esquimalt and Songhees. Members from the rest of the committee are all over British Columbia, and we recognize and honour all of the First Nations territory on which conduct our work. We are meeting today to carry on the consideration of the estimates of the very hard-working Ministry of Health. This is our second day, I believe. Minister, do you have any comments you’ d like to make? Hon. A.

Dix: Just briefly, I had promised an answer to the member from Richmond East before the break with respect to alleged abuse reports in the health care system registry in B.C. Since 2010, there have been 822 alleged abuse reports that have been received from employers, with all reported HCAs immediately removed from the registry. Of those removed, 426 received temporary suspensions, and 396 were terminated by their employers. Of the 396 termina- tions, 155 HCAs were removed uncontested, and 39 were returned to the registry by mutual agreement between the employer and the union without investigation.

Investigations were initiated for 202. Of the 202 invest- igations, to date, 197 have been completed, with 33 HCAs deregistered, 109 re-registered with conditions and 55 re- registered without conditions. Currently, there are five act- ive investigations. The Chair:I now recognize the opposition critic for Health, the member for Kelowna–Lake Country, to either carry on questions or give us a bit of an indication of how you’re going to use your time as a caucus. N. Letnick:Thank you to the minister. A lively morning this morning and, of course, a full day yesterday, and we have this afternoon to look forward to.

We have approximately 25 MLAs from all around Brit- ish Columbia and political parties that have some ques- tions for the minister — everywhere from five, seven-and- a-half minutes — starting, actually, with the first one from the member for Vancouver-Langara at 15 minutes. My job is to stay in the background. I will try to quarter- back all these wonderful MLAs as they ask questions, most of the time specific around their particular ridings. Some- times that might leak into provincial matters, but hope- fully not too often.

We’ll try to keep the questions as succinct as possible, some of which have been received by the minister in advance. Of course, it’s up to the minister as to how long he takes to answer them. I have no control over that. What I do have to say is thank you, again, to the staff at Hansard and everybody else who’s running the show. Without any further ado, I will go in the background. [1:35 p.m.] M. Lee:I appreciate this opportunity to ask questions to the minister relating to George Pearson Centre. George Pearson Centre is in the heart of my riding that I represent, in Vancouver-Langara, at 57th and Cambie.

As the minister well knows, of course, it’s a long-term organ- ization and facility that’s been there for many, many years, taking very good care, for the most part, of those who have very complex issues — challenges with mobility and severe disabilities. There have been, of course, with the previous govern- ment and this current government, plans to redevelop the site. That certainly is occurring with Onni, the private developer, as well.

I’ d like to ask, first: since the last public update, what is the progress and the status of the redevelopment of the George Pearson Centre, the future home of a community health centre and a potential urgent primary care centre as well? Hon. A. Dix: Thank you to the member for the ques- tion. As he knows, what’s in question is a phased develop- ment. It has some complexity to it on the site, but it’s going to be transformative to the community and transformative to the neighbourhood. The member will know that the first homes for 44 indi- viduals are under construction now.

The proposed com- pletion and in-service date is the spring of 2022. The second-phase homes for 16 individuals are in the planning stage, with a projected completion in the first half of 2024 — subject, obviously, to developer construction schedules. The developer, in that case, is in the process of applying for a rezoning amendment to convert parcel C to a rental building and add market density to other partials. There is a public hearing going on that he will be aware of.

A clinical services plan with respect to the community health centre and the proposed UPCC has been com- pleted, outlining the population needs for the area. Designs have been completed, and we’re on the way. 317

As you know, that model of UPCC and community health centre has proven to be a very successful model, especially in this time of pandemic. I think that not just the site but the community is very, very well-suited in South Vancouver to that development, so we’re working hard on it through Vancouver Coastal Health. M. Lee: I appreciate that response, Minister, and the update. Certainly, I understand, of course, that in Vancouver South, there’s the highest density of seniors and elderly in Vancouver.

It’s the work that I do as a local MLA, work- ing with seniors and senior-serving organizations with my South Vancouver seniors network and various seniors for- ums and webinars. There has been, I would say, on the webinars that I host with those who are caregivers, volun- teers and leaders in our community who help support seniors, great concern, of course, for care homes and res- idential centres. Obviously, we’ve seen, with George Pearson Centre, before COVID, considerations of the challenges of care in that facility. I’ve certainly heard from constituents who have family members residing there.

As you know, George Pearson Centre doesn’t just serve residents who are in Vancouver-Langara. They have long-time resid- ents who are there from, from what I’ve seen, all over Metro Vancouver. Some of these family members that I’ve been speaking with and those who have written letters to the minister and have spoken lately, again, to members of the press and the media talk about the ongoing concerns around inad- equate care and poor conditions within the facility.

What we’ve seen, of course — certainly even in COVID-19 situ- ations here and the challenge that it is — is that there have been increasing concerns, raised by residents with disabil- ities and their families, about the safety and what has been seen to be repeated uses of bullying and conflict with other residents who have substance abuse challenges. [1:40 p.m.] This problem has continued to be very difficult for res- idents with disabilities who have had, of course, for good reason, for their own public health and those of the staff there as well, restrictions on their own freedoms, with a no-visitor policy and other safety precautions that they understood and complied with, while I see, potentially, those who are addicted to drugs not adhering to the same social distancing policies.

They continue to see visitors frequent the centre. We’ve seen, more recently, incidents that I’ve become aware of where one resident was smoking narcotics and set off the fire alarm. On another occasion, police had to attend at the centre. Residents have been found smoking crack and other illicit narcotics on the patio outside the facility, with the smoke from these illicit narcotics entering the rooms of residents when their windows are open. Of course, I know the minister appreciates that this would put the health of the residents in danger. With that long

preamble, will George Pearson Centre and Vancouver Coastal Health be provided with the resources needed to adequately manage the needs of those suffering from substance abuse issues at George Pearson Centre? Hon. A. Dix: Thank you to the member for his ques- tion. I know George Pearson quite well from people I used to visit, who, unfortunately, are no longer with us. But I know the centre and admire the people working there very much.

I know the importance of the community of family around the centre to everyone and the challenges the centre sometimes faces, as do all long-term care homes, in dealing with the people living there, the resident com- munity, which, in some cases, can be a mixed com- munity of people with sometimes very different needs and very different circumstances.

There are, of course, people at the centre with various cognitive impairments and, also, who are dealing with withdrawal management and other issues related to the other public health emer- gency, the substance abuse emergency, the overdose crisis that we’re facing now in B.C. A lot of precautions have been taken, and during this COVID period, it has been particularly challenging. There have been and are significant circumstances and physical distancing measures that have been put in place to ensure the people in the George Pearson Centre are kept safe, and staff are certainly fully trained to do it.

As the member will know, we have, in general — and this includes George Pearson — dramatically increased staff- ing levels over the last couple of years in the long-term care centres across the province. What I would endeavour to do, should the member wish it, is to engage with family members at George Pearson, perhaps with him. Perhaps we could do it, these days, by Zoom, back to back with meeting with the Alli- ance Française, because I owe the member a meeting, I think, in that regard.

We can have a Zoom meeting and engage with the fam- ilies to hear their complaints directly, and I’ll have people involved from Vancouver Coastal Health there at that time, and we can address what are kind of operational issues, but real issues for families. This might be better suited in that setting than us back and forth in an estimates space. I’ d endeavour and commit to do that if that works for the member. M. Lee: I appreciate the willingness of the minister, knowing how fully occupied he is these days and many months, for good reason, for the province.

I appreciate that you recognize, at least within this centre, the concerns that you’ve seen and some of the letters you’ve seen and other communications. I would very much appreciate that 318 Committee of Supply,

Section C Friday, July 24, 2020

opportunity to help organize with your staff such a virtual gathering — of course, with sensitivity and privacy consid- erations in mind — and to help facilitate that type of dis- cussion. I do think that the concerns, as you know, with long- time residents, those who have been there for some time and family members that…. I know a family where their parents visit every day, and they continue to see the chal- lenges with the care. Recognizing, of course, that the staff are doing as best as they can, but it’s a difficult situ- ation.

I just appreciate that, Minister, in terms of what you’ve said. [1:45 p.m.] Just to complete, if I may, two other points here. This will give you a sense, of course, of the concerns. That is, of course, appreciating that it is a mixed-use facility, and recognizing the staff focus and priorities dealing with those who have, perhaps, behavioural or temperament issues spurred by substance abuse and addictions. We rec- ognize that that is a consideration, certainly.

But those res- idents who have severe mobility issues or challenges with quadriplegia or ALS or other really complex care manage- ment issues are not getting the kind of care that they feel they need, of course, when there are competing priorities, let’s say, in terms of the staff time. One of the other issues, which I alluded to, but just to ask the question: will the Ministry of Health and the min- ister commit to rehabilitation of those who have substance abuse issues in health care facilities specifically designed and staffed for substance abuse rehabilitation? Hon. A. Dix:Thank you to the member.

It may be pos- sible, certainly, in one of our two remaining legislative weeks. Either next week or the week after, we’ll just arrange to add the meeting. I agree we can talk, perhaps, with his constituency staff and with my staff about how best to do that. It may be with a small representative group, which might be the best way to do it so as to maintain privacy. The member will know that there are 12 people at the centre who are assessed by the VCH overdose outreach team, who access substances. That’s a challenge at the centre. The staff is fully qualified to address that. This is an important centre in B.C.

I’ve met with mem- bers on both sides of the House about issues with long- term care as they’ve developed in different communities and different, specific care homes. This is an important care home with very significant challenges — high levels of staffing and highly trained staff but, also, just people with real challenges who need our support. I’ll just endeavour to do that. What we’ll try and do is get together in the next week or so and have Vancouver Coastal Health direct it so people can hear each other.

If there are issues that we can deal with immediately or make better, then we can work on that, which I’m happy and committed to do. I think we’ll easily be able to find time in one of those two weeks. M. Lee:Thank you, again, Minister for your willingness to do so. I appreciate that. Just two other quick points here in the time that I have. In terms of other concerns that we’ve seen from long-time residents, it’s been the continued concerns about the qual- ity of the food. Much has been found to be unappetizing and not healthy for residents.

The question would be: what is being done to ensure the safety and quality of life for the residents with disabilities? Secondly: what is being done to immediately ensure that the meals being provided to residents meet the standards that they should expect? Hon. A. Dix: An inspection was conducted, I under- stand, on July 8, 2020, at the site in response to expressions of dissatisfaction with the food at the neighbourhood meeting, which is the one the member may be referring to, on June 26, 2020. As a result of the complaints, the contractor did change the recipes in consultation with a dietitian.

Despite this change, there are ongoing concerns with the taste and visual appearance of the food, I think, at George Pearson. The menu there is approved by a dietitian. The review of the menu considers issues such as texture, colour, taste, visual appeal, and so on. There was a satisfaction study done in October 2019. I gather the rate of satisfaction was 80 percent in that study. The expectation, the standard, is 85 percent.

We have asked the operator to review the ongoing food complaints and include the residents in the process so that they’re fully integrated and, hopefully, start to see the change that they’ d like to see. Obviously, this is part of the challenge in every care home in the province. We know this. I know it personally. I know members know it from their families or other families or friends. Often what happens in care homes, as well, is that there is a supplementing of food and support from families.

Desserts and other things are brought in by family visits, which have been severely restricted. [1:50 p.m.] This has had, I think, consequences for the quality of life, which are — let’s just call them — incalculable for people who live in long-term care. This is true at George Pearson, as it’s true everywhere else. To a degree, the challenge on food is the loss of some of the traditional social supports that many people would expect to give, and it has had a deep impact on their lives. I regularly call people who send letters to me, about this subject, during the course of the COVID-19 pan- demic.

Not long ago, a family member called me about their parent and what it meant to them to have tea at three o’ clock in their care home. That happens much more inconsistently now than it did before. That may seem trivial to some people, or a small matter, but for them, that person, it was everything. It was something Friday, July 24, 2020 Committee of Supply,

Section C 319

they looked forward to. It was something in their day that was profoundly important to them. These issues are very important, and everybody — I mean everybody, all 29,000 people living in long-term care in B.C. — is struggling with that right now. It affects people differently, but I fully understand the impact on George Pearson. These are the steps that are being taken, with respect to the food provided by the facility, in order to deal with it. M. Lee:That’s all the time I have. Thank you very much, Minister, for your responses. C.

Oakes: First, I just want to thank the minister for his leadership and for his entire team. On behalf of the constituents of Cariboo North, we certainly appreciate the work and efforts that they have been making. I want to advocate today, to the minister, for increased supports for seniors in our constituency. Just a little bit of background on the demographic in Quesnel. If you look at the demographic of the 75-plus population, it’s forecast to almost double — 91.4 percent — by 2026 and to grow by 156 percent by 2036.

I think it’s also important to note that it’s projected that the cohort of 85-years plus will more than triple by 2036. Currently there is a waiting list for our complex care and long-term-care facility, which is Dunrovin Park Lodge, of 44 people. We regularly have ten to 15 seniors in our hos- pital waiting to get into Dunrovin Lodge at any time, and this wait-list can be up to a year. Our assisted-living facility, which is Maeford, has a cur- rent waiting list of 97, with up to a three- to four-year wait for someone newly placed on the list. That is if you can actually….

There are very strict guidelines on how one gets on that particular list. I just think it’s really important…. Based on the signi- ficant demographic growth that we are projected to see in Cariboo North for seniors in our region, we need addi- tional both assisted-living beds and complex care/long- term-care facility beds in Quesnel. To the minister: I’m hoping that you may have an update for me. Hon. A. Dix: In terms of Quesnel, the member is right that one of the things that Northern Health has tried to do in Quesnel — and, I think, done a better job of in recent years — is on issues around home support.

That has been made necessary by the demand, especially the demand at Dunrovin, and the impact of the lack of long-term-care beds, or the lack of a sufficient supply of long-term-care beds, creating ALC bed demands, alternate-level-of-care demand, at Baker Hospital. As the member knows, just this past week Interior Health — which, I realize, is the other health authority; Quesnel is in Northern Health — is adding 75 long-term- care beds.

Certainly, we’ll be looking to Northern Health to meet the increasing demand for beds across the region. [1:55 p.m.] I think it’s fair to say that if you look at a projection — I haven’t done it recently; I did at the time that we were working on the urgent primary care centre in Quesnel — of the demand and the growth in the community, in all the communities of the north, of people over 75, clearly we’re facing dramatic and significant new demand.

If I recall correctly, the increased number of seniors over 75 is approximately 100 percent, while the overall expecta- tion in the community is to stay relatively stable. So clearly, this is an ongoing need that will require planning. North- ern Health understands, I think, the need, for the future of Quesnel, to expand long-term care beds in the community. So we’re trying to find a way to do that. As you know, we have a major project in Quesnel at the hospital, and we’re adding primary care network sup- port and urgent primary care support and home support.

But inevitably, the share of the population that requires long-term care is a subset of the population for seniors. The population for seniors in a community like Quesnel is growing like this. We can expect very significant change. The Northern Health Authority is looking seriously at…. Of course, the other part of this that the member will know is the need, ultimately, to replace Dunrovin, if memory serves at least from the last time I toured it. She probably goes there quite regularly and has a sense of the place.

Part of the opportunity in the business planning we’re looking at going forward is the need to replace those beds and then, at the time of replacement, add them. That’s probably the best plan in Northern Health. I don’t know if Northern Health’s best plan for Quesnel is to take the existing facility and to add capacity on site, because there probably wouldn’t be a sufficient demand for beds to have a sort of formalized RFP process for 100 beds, which is not what we need, from a private sector pro- ponent.

So in that case, probably the process that needs to happen, at Dunrovin, in any event, of improving the exist- ing facility will be the occasion to add the necessary beds. C. Oakes:My time is up, but I’ll quickly put in one more quick question. I really do appreciate the support that has been made available in Quesnel and appreciate the supports in Interi- or Health. Our riding does cover a small portion of that as well. So we appreciate that. The total direct care hours per resident in our long- term-care home of Dunrovin in 2017-2018 was 3.56 hours per resident.

For 2018-2019, the care hours per resident is 3.42 hours. I’m just wondering why the decline in care hours per resident. Why has that declined? Hon. A. Dix:I don’t have that answer off the top of my head. But, I say delicately, across Northern Health…. 320 Committee of Supply,

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Northern Health is a very different health authority for long-term care than all of the other health authorit- ies. The average in 2017 of funding across health author- ities was about 3.06 other than Northern Health, and in Northern Health, it was 3.39. It’s partly because it’s essentially all health authority owned and operated in Northern Health. We have increased funding in care hours in Northern Health from an average of 3.39 to an average 3.45. That’s across Northern Health. That’s the direction, which means there been increased funded hours.

What I’ll do is I’ll endeavour to get a detailed answer for the member as to what’s going on at Dunrovin. That sounds contrary to that. D. Ashton:Minister, always a pleasure to see you. Minister, I just want to say thank you to you and espe- cially your staff for being so proactive in taking over the issue that transpired in the Summerland Seniors Village and also with, apparently, the other four entities that are run by an off-shore company. That proactivity is going to make a difference.

However, at the current time, there are still issues that are in place at the Summerland Seniors Vil- lage. [2:00 p.m.] I’ d also like to say, through yourself and the ministry, a real shout-out to Susan Brown, the head of Interior Health, who does an exemplary job and is very quick to respond when questions from myself and others come forward. So please give credit where credit is due. Like I said, she is doing an exemplary job. However, Minister, I would ask if the opportunity would exist for a meeting with yourself and senior staff to discuss the ongoing issues at Summerland Seniors Village.

Over the last week, my phone and my emails have been ringing off the hook about ongoing concerns at the facility, not only in the full-time-care side, but also on the assisted liv- ing, which I understand Interior Health is not in charge of at this point in time. Also, Minister, I’ve had a request for an opportunity for a company, a purveyor of COVID testing equipment. With your direction, I would appreciate where I could go to fol- low on that request and give the entity an opportunity to get involved in the bid process.

Minister, once again, thank you very much for that pro- activity on your behalf and the ministry staff. It is going to make a difference, but let’s get through this little rough period first and see if we can all make these homes work a lot better than what they were doing. Hon. A. Dix:On the issue of PPE, I will have my associ- ate deputy minister, Peter Pokorny, get in touch with you, Member, next week, to engage in that process. There are, of course, centralized processes of govern- ment that are dealing with that as well, but the team led by Mr. Pokorny has done an astonishing job of obtaining PPE.

Just to put it in context, while there have been major efforts by the federal government on N95 respirators, 95 percent of the six million we’ve received have been pro- cured by the provincial government, the Provincial Health Services Authority. Mr. Pokorny will follow up with you, I’m sure. On the question of Retirement Concepts, as you know, Summerland is one of four facilities that are currently under administration in Victoria, in Nanaimo, in Comox- Courtenay and, of course, in Summerland. Some of the issues are site-specific in all those locations, and we’re working through them.

Some of those issues go through the organization of Retirement Concepts, which is a major player in long-term care in British Columbia. I won’t get into all the debate on that, because people have had it pub- licly. But we clearly are working to take steps to make the funding of long-term care more accountable to the public. It is not our preferred solution. In fact, I think that what we’ve done, putting a facility under administration, has occurred only six times in the history of the act, four of them in the last year. All four are related to Retirement Concepts.

One of the previous ones that was done under the previous government was also Retirement Concepts. These are issues we have to resolve. In fairness to them, there have been new managers in place — new manage- ment in place — and a new collective agreement, I under- stand, and other circumstances that are improving the situation of Retirement Concepts. So some of the issues are local, and some are systemic. I would say that there was a licensing inspection in Summerland on May 6, 2020, which is an independent process even of the administrator. Many of the previous licensing infractions have been addressed.

However, there’s more work to do. We’re clearly not prepared to…. Interior Health is clearly going to continue with the administrator for some time yet. I would be happy to meet with the member. I think we have a couple weeks left of the session. And do that by Zoom — and with Susan Brown, who’s very much seized of this question, and others, as required — to discuss issues that are happening there, because it’s important to respond to those issues. I would be, certainly, happy to do that — to hear them.

Then you’ll know that Susan Brown, because you know that’s her approach to these things, will be work- ing at addressing those directly. D. Ashton:To the minister, thank you, and again to Susan Brown — exemplary on her responses. D. Davies: Good afternoon, everybody. Good after- noon, Minister. Thanks for taking the time for the ques- tions. I want to thank my colleague, our Health critic, for allowing me a few moments here to ask a question. [2:05 p.m.] Minister, I know that we have spoken at length over the past few years. I’ve sat in numerous meetings with the Friday, July 24, 2020 Committee of Supply,

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folks from Northern Rockies regional municipality and their council regarding air ambulance service to the town of Fort Nelson. Of course, Fort Nelson is not necessarily a regional hub, but certainly, many times of the year — espe- cially during the summer, where you’ve got eight hours of highway up to the Yukon border — if there’s a medical emergency, they end up in Fort Nelson, initially. There is a dire need to have an air ambulance station in the north, in Northern Rockies. There was a contractor that was being used, but his aircraft didn’t quite fit the criteria. It wasn’t a pressurized cabin.

I would hope that there’s an opportunity for the ministry to do what’s right. I mean, they don’t hit every single check box on what’s required for a medevac, but these are high-end aircraft that are more than capable of delivering patients as needed. I just want to highlight one quick point here, and then I’ll give the floor to you. I did send you a letter yesterday that you’ll have an opportunity to get your eyes on, which outlines some issues. We just had a 65-year-old gentleman that I’ve got to know in the past few years. He suffered quite a severe series of strokes.

He required medical atten- tion that was not fully able to be fulfilled in Fort Nelson. The doctor said that he needed to seek a higher level of medical care within the next few hours or there could be dire consequences. Of course, the medevac could not get there or provide that service to him. Fortunately, this family did have the ability. They chartered their own aircraft from Fort Nelson for their father to get the needed medical attention.

Happy to say that, while there is a long recovery for this gentleman, it is looking much brighter than it would have been had he not been able to look after himself in this issue. I’m just hoping that the ministry can really take a seri- ous look at how we can provide…. Again, we’re not expect- ing surgeons and such to be working out of Fort Nelson, but access should be no different than a person who lives in Vancouver getting medical access to look after them- selves. I’ll just kind of leave it with that.

Hopefully the min- ister can work something out with the contractor in Fort Nelson and we never have to worry about this again. The Chair:Minister, do you have any comments on that? I didn’t hear a question there, but maybe you did. Go ahead. Hon. A. Dix:I did. I think the member was saying: “I’ve got a problem here, and I want you to do something about it. ” That was the question, to summarize? D. Davies:That is correct. Hon. A. Dix: I never want to summarize the member’s question too much, but I think I got the gist of that.

Hey, look, we made a significant increase with improve- ments — he knows that, in his community of Fort St. John, of course, and in Dawson Creek, for his colleague the member for Peace River South — in ambulance service and in air transport services. One of the changes that was made on April 20, as part of our plan to deal with rural and remote and First Nations areas, was significant enhance- ment. If the member will look at theHansard yesterday, I won’t give him the lengthy response I gave about where those things are and the fact that we’re now assessing how we’re going to apply and reapply resources.

What I would propose to do is fit in his request and his letter into that discussion, because we’ve made some tem- porary allocations of locations of our increase in ambu- lance and in air ambulance service in the province, based on the specific circumstances of COVID-19. What COVID-19 tells us is that the closer you are to acute care, which is true not just in times of COVID-19…. In certain circumstances, we can bring people closer to acute care from rural communities.

Then, should they require that care — including, say, intubation with respect to COVID-19 — we would be able to give access and get access to that care. Those changes have been brought in with the Premier’s announcement April 20. They followed through on the three-year action plan for BCEHS. I have one other piece of good news for the member. For the first time in a long time, I believe I’ll soon be appoint- ing a member of the board of directors of Northern Health from Fort Nelson, which is something I think people from Fort Nelson have been asking me for, for years. That’s just a teaser.

He’s going see that ministerial order soon, and we’ll let him know. [2:10 p.m.] In terms of what Fort Nelson and…. Often other com- munities have received lots of representation. We previ- ously had two members from Fort St. John. We’re going to have one member from Fort St. John and one member from Fort Nelson, so that will be an interesting change. I think it will bring to Northern Health’s attention at the board level, more directly, concerns around maternity and ambulance services and other things that I frequently hear about from the community of Fort Nelson and the hon. member.

I thank him for his question, and that’s how I’ll be responding to his request. D. Barnett:Thank you to the minister for giving us the opportunity to ask our questions. I thank him and Bonnie Henry. The first question I have is a little lengthy. It’s about the Williams Lake Cariboo Memorial Hospital. I understand that the upgrades have started in the operating room, and soon we will have more specialists. We’re going to have orthopedics, and cataract and oncology, and that’s won- derful.

I know we’re moving forward, but my question is: will the full renovation and upgrade that was announced about six times still move forward in 2021? Hon. A. Dix: Thank you very much to the member. 322 Committee of Supply,

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I don’t know if it was…. It hasn’t been announced six times by me. As the member knows, there had been a concept plan produced on the Cariboo Memorial Hospital project around 2014, a master plan around 2011. That concept plan was still in the minister’s office. It hadn’t been signed off or approved by Treasury Board at that time. So in 2017, we upgraded the concept plan. At the begin- ning of 2018, we approved the concept plan. In fact, it was my first capital announcement as Minister of Health at that time, so I was particularly happy on that day to be in Williams Lake.

I had visited Williams Lake, as the member would know, during the wildfires in the summer of 2017 and really talked to the extraordinary health care providers who served the community in that time in that emergency. We had made the case for that, so we did that. Then the business plan was approved, on schedule, a year later, in 2019. The RFQ for proponents on the Cari- boo Memorial Hospital is on track. The bid closed July 15. So a week ago, basically. Five proponents responded to the RFQ, and their responses are being reviewed by the evalu- ation committee.

While that may not seem like great news, it’s actually great news, because we were frequently having trouble, in some cases, getting sufficient interest to build hospitals. In this case, five proponents, just as we got five proponents in Fort St. James. It’s such exciting news. The RFP will be issued to those five proponents in September, and the selection of the proponent is scheduled, I believe, for Janu- ary. And then off we go. D. Barnett:Thank you to the minister. I know we’re short of time here, so I’ll try to move quickly.

We do have an extreme shortage of family physicians in Williams Lake, and this has been going on for years now. They’re working very hard — the community, the doctors — to bring in some new family physicians, and it is a big concern. I get a phone call at least two or three times a week from people that cannot find a family physician, and I know how difficult it is. I know there’s a big shortage of them, but is there any- thing, Minister, that can be done to help these rural com- munities obtain more family physicians? We’ve got spe- cialists, but we need family physicians. Hon. A.

Dix:I think the short answer is yes. First of all, first point, I think Williams Lake and 100 Mile are great places to live, and they, to some degree, sell themselves in terms of the potential for family physicians wanting to live in a great community, both to raise families and to live. I think that, obviously, there’s ongoing and great potential there. [2:15 p.m.] There’s been a significant effort by Interior Health and the whole health system to recruit family doctors to smal- ler communities. That’s done under a number of programs, and the member will be aware of all those.

What we’re try- ing to do, as well, is not just have people there temporarily but have people taking up these positions full time. Part of the way we’re doing that is bringing to com- munities, such as Williams Lake and 100 Mile, primary care networks, which support, in a modern environment, family practice doctors to provide team-based care so that family practice doctors have the supports they need around them to provide care in the modern environment. This is how young doctors view care. Eighty-five percent of young doctors and resident doctors in the surveys we take want to move away from fee-for-service.

Using the mechanisms of primary care networks — and, perhaps, for Williams Lake, an urgent primary care centre — may provide supports to that. Y ou’ve always got to be careful, though. In Williams Lake, in particular, we want to work with the current community of doctors. We don’t want to bring about changes or to bring things in that will somehow displace so you end up adding someone and then losing some- one. But we are going to be advancing the other parts of the primary care community, including nurse practi- tioners, to support doctors.

In the efforts by Interior Health, Williams Lake is one of the communities in particular that Interior Health focuses on, but over time, less so 100 Mile for whatever reason — both communities. We’ll be working hard on that project, and I’ll take the member’s representation back to Interior Health as well. D. Barnett:Thank you, Minister. I have lots more ques- tions, but we’re out of time. D. Clovechok:Thank you, Minister, for this opportun- ity. The minister will know I’ve spoken to him various times about this, including the 2019 estimates.

The issue is around the Health Connections bus routes that operate between Golden and Cranbrook and also service the res- idents of the Columbia Valley as well. The minister will know that the Health Connections route is run in partnership with Kootenay East regional hospital district, the regional district of East Kootenay and B.C. Transit. Those decisions about fares, routes and ser- vice levels are made by Interior Health in the town, based on information and planning provided by the municipal systems program of B.C. Transit. Currently the bus is operating two days a week.

Since April 20, those days are Tuesdays and Thursdays. That’s been a very positive change, for the most part, because it addresses the issue of clinic closures during statutory holi- days, but it’s not enough. Last year in estimates, I asked the minister to consider increasing the services to more than one weekday as well as one day per weekend or once every other weekend. The minister said he would look into it. Friday, July 24, 2020 Committee of Supply,

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My question to the minister. Will the minister today consider increasing the services of the Health Connections bus by at least one weekday and one weekend in the East Kootenays? Hon. A. Dix:Thank you to the member for his question. I just want to note to the member for Cariboo-Chil- cotin, who might have left us…. I think she was going to ask about operational cuts in home care in 100 Mile. I can tell her that there have been no such cuts, and I’ll be responding directly in writing to her request for inform- ation about that. With respect to the bus, I would say that I did listen to the member last year.

The change to Tuesday to Thursday really reflected what I learned in that discussion, which is that frequently what was happening with the Monday scheduled day is that all of the statutory holidays would interfere with the travel and make the delivery of health care and people’s access to health care worse. So the Tues- day to Thursday is actually the direct result of our discus- sion in estimates in 2019. Just to put it in context, there hasn’t been too much change on the Columbia Valley

section — the Golden-to- Cranbrook ridership, the yellow

section — over the last two years. I have looked into that. I’m definitely open to hearing more from the member with this issue. As he can see, last year we made a little bit of progress. The Tuesday- to-Thursday thing reflects that and reflects the commit- ment of Interior Health and B.C. Transit to work on these questions. [2:20 p.m.] On the question of a replacement bus, this is not some- thing that had been brought to their attention before, because I asked them about it this week. That’s something that Interior Health and their partners, B.C. Transit and others, will look into.

What I think we want to see, and what I’ll review and share with the member…. The substance of that continu- ing review is about participation on the bus and the poten- tial for increasing services. I would expect to see some increase in participation, in ridership on the bus, because of the change we’ve made over the course of the year. Obvi- ously, ridership has been way down in recent time because of COVID-19, but that’s not a representative period. D. Clovechok:Thank you to the minister for his sup- port in making those changes. They have been effective, as I mentioned.

Hopefully we’ll be able to find another spare bus. My last question, very quickly. Prior to COVID-19, I know I had spoken with the minister on several occasions about the issue between Alberta and British Columbia health care services. I live in a border community, as the minister is well aware. We’re still finding those issues of Alberta not accepting British Columbia patients. I did speak directly with Minister Shandro in Alberta about that issue. He was quite surprised to hear about it. I know that the minister is very well aware of this.

I’m just wondering if you could provide any updates as to where that might stand, given that COVID-19 has con- sumed the majority of your life over the last four months. Hon. A. Dix:It’s an ongoing issue of concern. It’s related to the previous question in the sense that I think what we have to try and do — in addition to access to acute care, which continues to be an ongoing problem — is improve the link so that people have access to regular care. Frequently, when we’re talking about Alberta, we’re talk- ing about access in emergent circumstances.

That access is continued, in fairness to people in Alberta, in the region, fairly uninterrupted. Access to scheduled or elective surgeries was the most significant problem that was being provided. Of course, it’s a challenge with the size of the Interior Health Authority. While capacity is there, and has, in fact, been significantly increased in many areas for surgery in Interior Health, often that is far, far away from the communities that he represents, and obviously, other locations are better. He should know that we have been having regular meet- ings on these issues with Alberta Health Services.

I have spoken to Minister Shandro myself on a number of occa- sions about these and other issues that are of joint interest. He and I have worked together on a number of issues of joint interest and have a very positive relationship. Our discussions of these issues have been suspended, as he would expect, since March 2020. But we’re hoping to pick those meetings up. What I’ll try and do….

I shared with him last time detailed information about transfers, both in the Kootenay area but also in the Peace area — shared information about what’s been provided and what hasn’t, what we’re paying for and what we haven’t paid for in recent time — so he has up-to-date information. Obviously, this period won’t be representative in that regard because it’s the period of COVID-19, unless people are travelling, period. E. Ross: I’ll change my first question to a request, if I may. Nav Canada actually shut down services to the Terrace airport during the COVID crisis, due to man- power and some other issues.

I’ve done some digging, and I found out that they never actually consulted the B.C. government or your ministry. Therefore, from 10 p.m. to 6 a.m. every night, we couldn’t get flights out of Terrace — even air ambulance. What I asked the federal government was: “ At least, could you consult with the B.C. government?” Actually, the B.C. government made Terrace a regional centre for COVID cases. [2:25 p.m.] My only request, Minister is: could you open up a line of communication with Nav Canada to actually help us con- 324 Committee of Supply,

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tinue to be the regional centre for COVID? It kind of con- tradicted the idea of us being a regional centre. My real questions are on Mills Memorial Hospital. Is it on schedule? Is it on budget? Can we confirm that the CBA will not apply to this project? And is the ministry expect- ing a labour shortage, considering the COVID crisis, as well as the labour market being taken up by LNG and LNG initiatives? Hon. A. Dix:Y es, yes, yes, no, I think, are the answers. I think I got them right, but sometimes when you say some- thing like that, you get the questions in the wrong order. Then you have a problem.

On Nav Canada, I wanted to let the member know that during a phone call with BCEHS on July 20, 2020, Nav Canada announced they are reinstating night service to all affected flight service stations in the province as of August 4, 2020. They’re in the process of sending out official noti- fications to stakeholders. I agree with him about the concern. In particular, on May 16, there was an issue involving a patient in ambu- lance traffic that he may know about. We’re obviously very concerned about that. We have been, and B.C. Emergency Health Services has been, in touch with Nav Canada and had that confirmation.

While that’s not tomorrow, it is August 4, and that’s positive news given, as he says, the central role that Terrace and health care in Terrace plays in our COVID-19 response in the region. With respect to Mills Memorial Hospital, we are on track. The project is still within its approved budget. The member will know that the northwest hospital district’s contribution, because sometimes the concerns about budget is pressure on the local tax base, in this case, is 25 percent. If he would not tell any of his colleagues who are in communities where they pay 40 percent, I’ d really appreciate it.

Just don’t make them available at all. In particular, don’t call the member for Peace River South, or anyone like that. Thank you. So that’s some positive news. Just to say, on the labour shortage question, the pro- ponent we have, with respect to the modified RFP we’re doing and engaging in there, hasn’t indicated in their pres- entations any concerns with labour shortages. J. Thornthwaite:Thank you very much, Minister. I have one question about seniors.

It pertains to a letter that you would’ve gotten from the residential care family council, pertaining to Evergreen House, which is the long- term care facility on the Lions Gate Hospital campus. They gave a lengthy letter. I’m not going to go into in any detail. Just to summarize the issues, they call it a special commission report, and they’re actually asking for specif- ic action from government to help with the long-term care facilities due to COVID and moving forward.

They’re worried about what’s going to happen in the fall if there’s a second wave and also with the flus; as to what is happening with these plans for changing the resident rooms from four in a room to private rooms; making sure that there’s a nurse on every shift; full-time care aides to ensure that the residents are properly cared for in a time- ly manner with those staffing. We know that during COV- ID — and it happened at Lynn Valley as well — the family members were left to care for a lot of the residents because there was simply not enough staffing. Also, the Plexiglas dividers for visitors.

Apparently, the families were asked to pay for that. So of course, we are requesting that government pay for the Plexiglas dividers. And just briefly, also to ensure that when family mem- bers have questions of communication issues, including resident calls on the call bells, that they, obviously, be answered in a timely manner. [2:30 p.m.] I’m just wondering if the minister has reviewed the let- ter from this group and if he has a response or if a response is coming. Hon. A. Dix:As the member will know, I met with the family council some time ago at Evergreen House.

We had a little bit of a discussion this morning, in our discussions about seniors care. Obviously, significant steps have been made to increase and improve the quality of care across the system. The situation at Evergreen House is a situation of some significant number of long-term-care facilities that are health authority–owned and –operated. Historically, they’ve had higher levels of staffing, and Evergreen has been over the 3.36, but they are older facilities. They’re facilities seemingly from another time and not as modern.

In the previous couple of decades, there has been relatively little investment in the existing health authority–owned and –operated stock of beds. The focus has been on the addition of private long-term-care beds, public beds that are funded under contract. What we have, if you look at the stock of beds in health authority–owned and –operated, you’ll see the significant share of beds that are no longer or are not single rooms and an older stock.

One of the things that I spoke about this morning — and Evergreen is one of the facilities I had in mind — is that, ultimately, what’s required at Evergreen is a new facility. That is one of the older facilities in B.C. It’s critically important on the North Shore. There are hun- dreds of beds in the facility. From memory, I think it’s close to 300. I’ve toured the facility more than once myself. As we build an extraordinary acute care centre at the Lions Gate Hospital, really one of the challenges as Min- ister of Health is that there’s an ongoing acute care crisis in capital in Health.

It’s why we’ve been approving — part of this afternoon, we’ll be discussing all those projects — acute care projects across the health system. There’s also a capital investment question in long-term care, which has been neglected over a period of time. It just has been, and we have to address it now. Friday, July 24, 2020 Committee of Supply,

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I would think that that capital remediation challenge, across the system, is certainly in the billions of dollars, and a project such as Evergreen, in the current concept, would be more expensive than some of the hospital pro- jects we have around B.C. It’s a priority, and we’re very focused on that. With respect to the letter from the family council, I’ll be happy to…. I’ll certainly be reviewing it and responding to it. I will most assuredly copy the member on that response. J. Thornthwaite:I just have one more follow-up that I’m allowed to do. Okay, then, Minister. Thank you very much.

This let- ter was dated June 4, so it is definitely pertaining to the issues that occurred with COVID but, moving forward, to all of the changes that need to occur in long-term care and that have been itemized elsewhere, including from the B.C. Liberals. My final question is: where is the new facility for Ever- green House in the capital projects? Hon. A. Dix: Those are priorities. I think what I’ve said is that if you look at the acute care projects in Van- couver Coastal Health, we’re doing a significant project at Lions Gate.

We’re doing the projects around the Pear- son site that I just talked to the member for Vancouver- Langara about. We’re doing — even though it’s a Provid- ence project, it’s sort of in the Coastal Health area — the multi-billion-dollar project at St. Paul’s. We’re doing the Richmond Hospital project. We’re doing multiple long- term-care projects, including ones in Richmond that I’ll be talking about shortly. We’re certainly focused on building a long-term-care capital plan — that’s been missing, in fairness, for decades, well back into the 1990s — to remediate existing long- term-care homes.

What I can tell the member is that when I think of that plan and when I think of ensuring that that plan is funded in the province, one of the first priorities I have in my mind — and, I’m sure, in Vancouver Coastal Health’s mind — is Evergreen. J. Isaacs:Good afternoon, everyone. Thank you to the minister and his staff for being here. Thank you to the crit- ic for the opportunity to participate today. [2:35 p.m.] There were over 2,000 deaths in Canada in 2018 that have been related to influenza. Of course, as we get older, our immune system weakens, and we are more likely to contract the flu.

As the minister knows, influenza is a highly contagious viral infection, and outbreaks often occur in shared spaces. We have seen the impact of COV- ID outbreaks in long-term-care homes. However, flu out- breaks have been occurring for a number of years. If some- one has a compromised health condition or a comprom- ised immune system — like heart and stroke, kidney dis- ease or lung conditions — they are at a much higher risk of influenza-related complications, which includes death. The B.C.

Immunization Council announced in late June that the federal government bought all of the available doses with the intent to distribute to the provinces high- dose flu vaccine. Eight out of 13 provinces already have a high-dose flu vaccine program. As I understand it, 45,000 doses have been allocated to the province of British Col- umbia — 31,000 for long-term care home residents and 14,500 that would be unaccounted for. Can the minister advise if he will be accepting the offer of 45,000 doses for high-dose flu vaccine and will that access go to the 31,000 people living in long-term care homes?

What are the plans with the remaining 14,500? Does the government plan to provide access for high-dose flu vaccine for people living in long-term care homes in future years? If so, would the government cover the cost of that high-dose flu vaccine? Hon. A. Dix:As the member will know and as members of the House will know, the onset of respiratory illness sea- son is something that we are preparing for now and that we are highly preoccupied with. That includes long-term care, but it also includes other seniors, other communities and the community at large. That’s for obvious reasons.

First of all, influenza itself is a serious challenge every year for the province and for communities across the world. Secondly, because, in the context of COVID, influenza mirrors many of the symp- toms that COVID-19 has, the potential for that and even an increase in the common cold will have a significant and disruptive impact on lots of communities of people and workplaces. We’ll be laying out soon a detailed plan for the fall for our response to influenza. I think everyone in B.C….

That plan would come under both my direction and the direc- tion of public health, which is responsible for its imple- mentation to the health authorities. And our deputy min- ister, Steve Brown, that…. We will be laying that out for the public fairly soon. The federal government has made an offer with respect to high-dose flu vaccine, and that offer, as one would expect, was accepted. It’s a one-year offer, of course. We have to assess, each year, our plans with respect to care.

The 31,000 doses, as the member suggests, or approxim- ately that — it will be slightly more than that because there are slightly more than that number of people involved — will go to long-term care. I would say this. Often the risks of people with respect to flu vaccine are even greater in the community, so it will be important for all of us….

When I announce the pro- gram that we’ll be going out with, in the fall, I’ll be ask- ing all members of the Legislature to join with me in in promoting the influenza shots, flu shots, showing leader- ship on flu shots, promoting flu shots, telling people why they’re important to have this year. As part of a genuine 326 Committee of Supply,

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team B.C. effort around that, I think we’ll have to work hard to make sure that we increase the level of coverage from the flu shots that we’re getting this year, which will include the 45,000 in question. [2:40 p.m.] J. Rustad:Two questions that I’ll ask as sort of just one monologue here for you to be able respond to. The first is regarding two capital projects. Fort St. James hospital. I heard you mention that five people — I think it was five — had submitted on the project, which is good.

I’m just curious as to the time frame in terms of construc- tion — when you expect that contract to be awarded and when you’re expecting shovels to enter the ground. The second is just the capital project, the health facility or the health clinic in Vanderhoof. Y ou and I have had a conversation about that. I just thought I’ d give you an opportunity, on the record, to explain if you’re working towards a solution for that clinic. Obviously, it’s critical for health care services in Vanderhoof, and with the status of that clinic, action is certainly needed as soon as possible.

The second part of the question, which is a little more complex and a personnel question…. If you need to give it to me in writing, that’s fine. Smithers, for many years, has been advertising for a radiologist. A very qualified radi- ologist from Prince George applied for the job. The folks in Smithers were very excited because of this individu- al’s qualifications, only to find out after this person from Prince George applied that the job posting was pulled.

Upon looking into the job posting, apparently it was filled with an individual who is currently still two years away from finishing training in the United States. The question to the minister on this is: why would that position be filled with an individual who isn’t even fully qualified and is several years away from being able to provide services in the Smithers and northwest region when somebody very qualified with many years’ experi- ence had applied? The medical team in Smithers was very excited about having her come in as part of the team. Like I say, you may not be able to answer that question right out.

If you want to give me that in writing, that’s fine. But I thought I should ask those questions. Hon. A. Dix: I owe the member a phone call. So I’m feeling bad. We’ll get to that, one phone call at a time. I appreciate that. I’ll have the discussion on the person- nel issue. Obviously, I’ll ask Northern Health to look into it, and either the Northern Health president or my team will get back to the member about that question. Usually we don’t have extensive discussions of personnel issues, so there are always some privacy considerations involved. But I’ll ask, and we’ll get some answers.

On the Stuart Lake Hospital — holy mackerel, five pro- ponents. It’s exciting. As the member knows, on December 19, the business plan was submitted to me 14 months after the concept plan, which is, if you look back over the last 15 years of projects, a very, very good result. On January 18, the Premier announced the approval of the business plan. The RFQ, the request for qualifications, April 9 — five pro- ponents. Did I mention there were five proponents? It’s so excit- ing. It closed on June 18. Now the RFP will be issued to the shortlist of proponents in July, in this month. That’s all good news.

Like many capital projects, while COVID’s been going on, because of the energy that Northern Health is putting into this important project, we’re zipping along on schedule. With respect to issues around the primary care update in Vanderhoof, the member will know that we’re cur- rently involved intensely in primary care network plan- ning for a number of communities, including Vander- hoof — in fact, an important community.

There are two local health areas, community health service areas, involved, Vanderhoof and Vanderhoof rural, which have about 8,600 people combined — 6,000 in Vanderhoof and 2,685 in Vanderhoof rural. [2:45 p.m.] The issues that he refers to will be dealt with as the service plan is completed in September. That was delayed somewhat by the onset of the COVID pandemic, but we’ve taken, obviously, a number of steps in the interim period in terms of virtual access to improve access to care in First Nations and in the community at large. The member will know about that. We would expect….

The preferred option, as he knows, is the team space at 3299 Hospital Road. It’s one of those things. The land is owned by NHA, but the building is owned by Citizens’ Services, but that’s not really a prob- lem. We’re looking at that site for a project, and we’re on the road. I think we’re going to see action on that fairly soon. Obviously, it has huge support and lots of planning and development, in terms of not just the physical space, but in terms of the services we hope to provide in that region.

I think that, and the work being done in Vanderhoof, and we’re looking at other work as well with respect to assisted living, of course, combined with the hospital in Fort St. James, means that the Vanderhoof–Fort St. James corridor there will see, in the coming years, a significant improvement in the quality of care and its ability to attract people to the region to provide the care we need in the future. J. Rustad:I’m sorry. I may have missed it. I asked about the

schedule for awarding of the contract and potential construction date for Fort St. James. I’m not sure if you had that in the answer or not. If you did, I’m sorry I missed it. Hon. A. Dix: The RFP is going out in July 2020 to the proponents. So we have qualified proponents. At that time, we’ll have a detailed

schedule for the next phase, which is the RFP phase. Friday, July 24, 2020 Committee of Supply,

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We’re moving on and ready to go on that project. It’s on time and on schedule. They’ve met every deadline, and I would expect them to continue to meet the deadlines. In particular, the procurement deadline I would expect to be completed fairly shortly. It will be announced at the RFP process, and obviously there will be a successful pro- ponent, and then we’ll be beginning construction, I hope, before the end of 2021. J. Y ap:Good afternoon to the minister. I appreciate the opportunity to participate in estimates of the Min- istry of Health.

My question is in regards to a project in my riding, Richmond-Steveston, which I know that the minister is aware of, and that is the Richmond Lions Manor–Bridge- port, also known as the Fentiman project. This is a seniors long-term-care facility. The community has really been hopeful and expecting this project to be developed. Last year in estimates the minister gave us kind of a status update, and I’ d like to ask the minister if he could provide us with, again, the most current situation with respect to the Fentiman Place project. Hon. A.

Dix: I wanted to thank the member for the work that he’s done, along with other members of the House, on our committee we developed with the seniors advocate, Isobel Mackenzie. I’m very appreciative of that work. He knows, and we all know, both its value and the number of seniors served. I very much appreciate that everyone chose to step up and participate in that in March. I can tell you that the efforts of MLAs have been felt all over the province. With respect to the Fentiman project, it’s a priority. Business planning is underway, which is a good sign.

A consultant was hired to update the clinical services plan and functional program to ensure that it aligns with the long-term-care guidelines, which you’ d expect, and addresses the lessons from COVID-19 in this part of the development. Following this work, VCH will develop cost- ing and complete the business plan. I expect that the busi- ness plan…. I’m told the business plan will be submitted to the Ministry of Health for review and approval in the fall, and then we’ll be going forward with the budget. J. Y ap:That’s excellent. Thank you, Minister, for that update. L. Throness:Good afternoon to the minister.

I just have two questions. One is from Chilliwack. [2:50 p.m.] People from Chilliwack, especially seniors, have to go to Abbotsford to receive injections for macular degeneration. We have two great ophthalmologists in Chilliwack. There’s a lot of travel involved. These ophthalmologists could be qualified to do injections here. We’re wondering what the benefit is for them to do it in Abbotsford? It’s just an extra cost to the ministry and to our seniors. I wonder if the minister could comment on that for me. Hon. A.

Dix: Well, the member will know the issue of the retinal program was one that I asked about extensively as an opposition MLA, so that’s a bit of history. It was more than ten years ago, so I can’t quite remember what I was saying or whether it was similar to what the member just said. I think I was asking about Vernon at the time, if I’m not mistaken. In any event, the retinal program is an extraordinarily efficient program. In fact, the number of people who are served in B.C., compared to many other jurisdictions, and the costs which are served, is really extraordinary.

It has been the subject of a recent review, as a program. But the purpose of the program is to have the macular degener- ation program delivered by 29 retinal specialists. This is what the treatment program is. One of the challenges with that…. There have been advantages in that, in terms of efficiency and how the pro- gram is delivered, which is quite effective. But of course, other people who would like to join the retinal specialists in the group have long argued they’ve been excluded.

There are advantages, though, in terms of quality control in the work that we do in this program, which really affects the lives of thousands and thousands of seniors every year — indeed, tens of thousands. There are six retinal specialists in Abbotsford. I know that is an inconvenience for people in Chilliwack, just as previously, the lack of retinal specialists in Vernon — where they’re centred in Kelowna — was a frustration there. That is the nature of our program.

The current ret- inal specialist program, which was set up, I think, in the years around 2007, 2008, had as its basis, its agreement with retinal specialists, which was designed to ensure quality of care. It served us well over time, but I take the member’s point and concern. But I don’t see any changes to the fundamental underlying basis of the program, which is to have it run through those 29 retinal specialists around the province and not to expand out the number of spe- cialists at this time. But I understand the concern and the concerns of the people in Chilliwack.

It does seem a bit unfair that there are six in one place and none in the other. That’s not an unusual circumstance in the pro- gram around the province, but I don’t think we’re likely to change it any time soon. In any event, we’re certainly reviewing the program now, and we’re doing regular quality reviews, given the seriousness of macular degeneration and what’s at stake for people in terms of their eyesight. It’s a program where quality is also important. That’s not a criticism of the oph- thalmologists in Chilliwack.

The intention of Minister Abbott, if I remember cor- rectly, who instituted the program, was to ensure quality 328 Committee of Supply,

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in the delivery of the macular degeneration injections and that that would be done best by using retinal specialists. L. Larson:To the minister, just a comment and a ques- tion.I’m, as well, in the South Okanagan and have many calls from people who are without a family doctor. I am one of them. I have been without a doctor since the first of March. I have been on the list since then, and I have yet to have a call. So it is very much an issue, and it’s something that my office hears about almost weekly, for sure. My question, though, to you, Minister, is…. We have talked before about Princeton.

I’m just wondering whether there has been any work done on capital project or any types of upgrades for the Princeton Hospital. I know that the foundation over there has started to do some fundrais- ing. I just wondered whether or not there was anything on your capital horizon. Hon. A. Dix: First, on primary care, I’m in the same situation as the member in terms of a family doctor, although I do, because of my diabetes, have an endocrino- logist. So I’m well served by the system, but like many people in B.C., the retirement of our long-time family doc- tor has that impact, and it does on lots of people.

So I appreciate that. [2:55 p.m.] In the South Okanagan primary care network, so far, which is one of our regional primary care networks, has been, I think, on balance, an extraordinary success. It’s focused to date on Summerland and Penticton, as the member knows, but we’ll be pursuing opportunities in Oliver, Osoyoos, Keremeos and Princeton. This is a part- nership of the division of family practice in Interior Health. We’re in year 2. We’re providing approximately $4.4 mil- lion in additional annual funding to meet net new primary care services, which is important.

The funding amount will increase — that’s for the current parts of the primary care network — when we add Oliver, Osoyoos, Princeton and Keremeos as we build out the primary care network shortly. The SOS, the primary care network, so far has shown ability in Penticton, including the establishment of a brand-new, team-based primary care clinic. That’s in Pen- ticton, at Ponderosa, but it shows the effectiveness of this model, which we’ll be bringing further south in the Okanagan shortly.

Nine new family physicians, five new nurse practition- ers and ten allied health practitioners have been recruited to the region. That approach is going to be applied in the rest of the community shortly. I think the work of people in the community, the priority, the importance of this primary care network and issues around the hospital in Oliver are significant issues, which we’re focusing on. That primary care network is essential and important. With respect to issues in Princeton, they will be, of course, part of that primary care network. We are looking at build- ing out more primary care in Princeton.

In terms of an update around capital projects in Prin- ceton, what I’ll do is I’ll get some information to the hon. member by the end of next week, just to give her a full update on plans and ideas around Princeton, so she’ll be able to have that for her constituents. L. Throness:I did have one more question for the min- ister. That was about a personal constituent problem, but it is applicable to other people around the province and to other constituents of mine as well. My constituent, Angela Hutchinson, has Parkinson’s disease and is facing a four-to-five year wait for deep brain stimulation surgery.

Four to five years, as you know, is a very long time for persons with Parkinson’s. She can get her deep brain stimulation surgery in Saskatchewan with a one-year wait. “On June 4, I wrote to the ministry just a generic email. It just goes into a black hole. Y ou know, I don’t know who to contact or anything. I asked for permission to under- take the surgery in Saskatchewan based on the portabil- ity provision of the Canada Health Act. I’ve received no response. ” I’m wondering if I can get a response from you today.

Will my constituent get permission to go to Saskatchewan, no doubt at the same price that they’re going to pay in B.C., but in one year instead of four to five? Hon. A. Dix:What I’ll endeavour to do is get the mem- ber a response to his specific question. I think the issue with respect to deep brain stimulation is one that he’s aware that I’ve taken, I think, some extraordinary action on, supported by Dr. Honey, who’s the lead surgeon who provides this surgery in B.C. We’ve also added, as he knows, other doctors who are able to do battery replacement, freeing up Dr. Honey to do more surgeries.

He’ll be aware that in the 2017-18 fiscal year — and really in the fiscal years before that — British Columbia did 32 deep brain stimulation surgeries in the province. In the past year, that number increased to 72, which is, I think he’ d agree, an extraordinary increase, especially considering the time it takes to do the surgery. I think that’s a significant improvement. The challenge, as he suggests and many people with Par- kinson’s disease would say, is the challenge in getting a referral to the surgeon, which would be an issue regard- less of what jurisdiction you were going to.

Y ou would still need a referral for the surgeon. I don’t have the details in front of me of the case, and it’s really not the kind of thing one would discuss publicly in estimates, in any event. But I’ d be happy to get back to the member by the end of next week. [3:00 p.m.] M. Bernier:Good afternoon, Minister. I let you off the Friday, July 24, 2020 Committee of Supply,

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hook last year with my questions, but I know you have them in advance. I know the minister has these. I’m just going to quickly…. For the record, I want to ask him again where we’re at — it can be a quick answer of just yes — on moving forward with the Dawson Creek Hospital. I know the minister…. I want to thank him, because after about ten years of working and advocating for this much-needed hospital, he came to my riding and made the announcement that we were moving forward. The Premi- er has also referenced it numerous times in his speeches as something that the provincial government is doing.

I’m just waiting for that doing to be done. I’m just curious if the minister can give me an update. I know it was going through a business plan. I know, because of the good relationship I have with not only him- self but on the ground here with people, the work behind the scenes that’s been going on. Just looking for the quick updates for my constituents. Hon. A. Dix: I was going to say to the former Health critic that they told me when I became the former Health critic that I couldn’t ask questions in estimates anymore. I don’t know what the rules are. The standards are clearly declining on the opposition side.

Seriously, it’s a huge priority project. We’re going to have an announcement very soon. The member knows it’s really exciting news. This is transformative news for Dawson Creek, because I believe, as well, in addition to building the hospital, we can take advantage of that to build out our capacity to train the health care workers and health care professionals that we need in the north. I think the health care facilities that were built by the previous government in Fort St. James and all the ones that are being built across the north help us in recruitment.

That’s an important issue in Dawson Creek and everywhere else. I want to acknowledge his support, the support, of course, of the mayor, the support of the whole community and the support of the First Nations for this project, of Treaty 8, which has been hugely critical to that consensus. I want to ask him not to review theHansard of my dis- cussion with the member for Skeena, where I referred to the project. I’m very happy that the community is provid- ing 40 percent of the cost. It’s all good, and we’re going forward soon. I’ll be telling him before an announcement is made. M. Morris:Good afternoon, Minister.

We’ve had excellent service over the past 20 years by the Northern Health bus connections, connecting all the communities in the north here for health services down south. The contract’s been in place now…. The last time it was put up for bid was 2006. They’re for four-year peri- ods of time, and it’s been extended with the same com- pany, now, ever since. We’ve got a local transportation company, well equipped to undertake this service. He’s been in contact with North- ern Health quite a bit over the last year expressing interest in bidding on it. But it wasn’t put on B.C. Bid.

The contract was direct-awarded to the same company again in March of this year. This company’s asking me to ask you what the province’s position is on these contracts. It’s a $4 million contract annually, so about $80 million has been expended on the service over the last 20 years or so. I’ d just like the minister to comment on how that process works and whether it will ever be out for a bid for other agencies to bid on. Hon. A. Dix: The member’s quite correct. The con- tract has been in place for 14 years, and probably 20 years from the beginning of the contract. It has not gone out for retendering.

I’ll just say delicately that I’m not going to speak to the first 12 years of that. I’ll just speak to the more recent peri- od. In 2020, as he’ll be aware, with the satisfactory per- formance of the existing vendor, Northern Health recom- mended that it be extended another five years. Indeed, it was, as he’s aware, in line with a contract provision allow- ing for a five-year extension.

That extension was done to March 31, 2025, and was supported by the Provincial Health Services Authority supply chain, which supported that recommendation. [3:05 p.m.] However, following the notice of renewal, there was a complaint issued under the process. I know this won’t be necessarily satisfactory to everyone, but Northern Health said to me that while it has been extended in this period…. That’s a challenge, I know, for an alternate company in the process. But what I’ve been assured, and what Northern Health is committed to, is that there will be a retendering in the next round.

I admit that that’s several years from now, but Northern Health is committed to doing that. The complaint itself is at stage 2. But part of what I’ d say, as well, is the retendering would take place for 2025. It will obviously have to occur in a tendering process well before that. I agree with him that it’s good to tender just in general, although sometimes I understand why that wouldn’t be the case when Northern Health is sat- isfied with the contractor. I think, generally, the com- munity is satisfied with the contractor in general — why they might have gone that route.

In any event, it won’t go that route the next time. That’s obviously a business decision by Northern Health, and a response to a complaint put forward in the process, which is completely fair and legitimate. M. Stilwell:Thank you to the Health Minister for the opportunity to ask a question. I’m actually here today to ask questions on behalf of the city of Parksville. The city of Parksville feels like they have been experiencing a significant challenge working with the minister because they have yet to receive the courtesy of a formal response in a bylaw that they submitted in accord- 330 Committee of Supply,

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ance with the provincial regulatory processes prior to the COVID-19 pandemic. The city, as many communities around the province, is experiencing many problems regarding improperly dis- carded hypodermic needles, both used and unused. In the efforts to manage the community safety risk in the city, the city abided by the ministry’s regulations, and they estab- lished some procedures and developed a bylaw. The bylaw was amended based on input that they received from the medical health officer in accordance with the regulation.

However, despite entering into the formal public health bylaw process in what they believe is good faith, and work- ing with the medical officer, the city has been denied that due process and, quite honestly, the courtesy of a formal response from the minister. In fact, the province accident- ally notified the newspaper of a neighbouring city that the bylaw was rejected. That occurred on June 2, 2020, and to date, the city still hasn’t received any formal decision or reason for that decision from the minister. Constituents in my riding want to have an answer to the issue.

They want to know if the minister rejected the bylaw, and if so, what reasons does he have to support that decision? Further to that, when can the city expect the courtesy of a formal response? Hon. A. Dix:Y ou can tell Ed, Mayor Mayne, that I’ll be giving him a call next week. M. Stilwell:To add to that, I believe the minister knows that council passed a resolution in the fall of 2019 request- ing a meeting with the minister and the medical health officer to find some mutually acceptable solutions to what is a very important community issue.

Y et despite many attempts to arrange that meeting by the city staff, the city, again, has not received any response from the minister’s office. I recognize that the minister says that he will call Ed next week. The proposed bylaw seeks to implement the use of retractable needles as a means to reduce community con- cern about the risks of needle sticks and exposure to the drug residue from used needles. The question now, really, is being raised whether or not the ministry is putting the cost — we do know that retractable needles cost more — ahead of the safety of the citizens.

The bylaw also attempts to control the distribution by identifying those individuals who are providing the needles in the community to sort of enhance the accountability for the numbers of used needles being improperly discarded around the com- munity and the volumes of unused needles that are being wasted. [3:10 p.m.] We know that the unlimited supply that is given is not actually required because we know that many of the people who are taking them can’t even carry the large volume of needles that they’re given.

Perhaps if an appropriate num- ber of needles were distributed, that could counterbalance the slightly higher per-needle cost that would support the introduction of retractable needles. That being said, I’m raising this question because wast- ing hypodermic needles during pandemic times has very serious ramifications for the people of British Columbia, in my belief. We are all watching this race to create a COV- ID vaccine with hope and with the fear of a second wave. It calls many things into question.

When that vaccine will be created, the question is: will there be enough hypoderm- ic needles to vaccinate five million people in B.C.? What is the government doing to build that reserve for the non- drug use of ordinary men, women and children around British Columbia? We saw the results when the federal government dropped the ball. We saw masks and other health supplies not in rapid supply when we needed it the most.

The gov- ernment has this opportunity now — and, quite honestly, a duty — to make sure that when that vaccine is available to be delivered to the people of British Columbia, as soon as it is developed…. What is their plan to make sure that there are going to be enough needles to go around? Or will they be misused, and will we continue to see new hypodermic needles thrown away by drug users who, not by any fault of their own, are simply incapable of managing their safe disposal or even keeping track of the unused needles?

I want to ensure that this government has a plan so that we have ample supply and to ensure that there will be enough needles in place when the vaccine becomes available. Can the minister tell me what the plan is? Hon. A. Dix:I think I would say, with respect, the con- flation of these two issues is really not one that merits too much discussion. Dr. Bonnie Henry, who is our provincial health officer, and our team in the Ministry of Health have been involved in multiple pandemics around the world, helping people on multiple continents. Dr.

Henry was a leader in the SARS fight in Toronto and helped lead British Columbia and others in the H1N1 issue, which involved very sub- stantial immunization as well, as the member will under- stand. Preparing for a possible vaccine is something that we give great focus to, both at the provincial and the national levels, and it’s a high priority for us. Obviously, that vaccine doesn’t exist yet, but the avail- ability, or putting together a plan for it, is not in any way related to how needles are used or misused by those in the community.

This is obviously a high priority for us, as is the development of a plan to address immunization for influenza in the fall, to deal with other immunizations in the system and to deal with medical supplies. I think Brit- ish Columbia has been a leader in that regard. With respect to the situation in the community, I would say that it is the same kind of advice that we get from med- ical health officers that guide these decisions as well. They don’t make those decisions frivolously; they take them very seriously. I know that the people of Parksville do as Friday, July 24, 2020 Committee of Supply,

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well. I look forward to speaking with Mayor Mayne. Until I make a decision and send a letter out, the decision is effectively not made, although the fact of a recommenda- tion was sent out, I think, and of a briefing note. I want to have that discussion with Mayor Mayne, and we’ll fol- low up subsequently in writing with the reasons for the decision. M. Stilwell:Minister, thank you for the comprehensive answer. I appreciate that you’re taking that time to reach out to Mayor Mayne.

I just want to confirm, then, on the record that you’re saying a decision has not been made by you at this time and that you are still looking at the issue but will have that discussion next week when you talk to the mayor. [3:15 p.m.] Hon. A. Dix:I’m saying that until a decision is commu- nicated formally by me, it hasn’t been made. Of course, the member will know the recommendation and the briefing notes were leaked out — not leaked out but sent out — in response to a media request. It was simply a mistake that was made.

That’s unfortunate, because that’s not the ordinary way we would want to conduct such a thing. I’ll be speaking with Mayor Mayne about it personally and then following up in writing with the detailed reasons, which is, I think, the appropriate way to communicate in these matters. I appreciate the questions from the hon. member. N. Letnick:Thank you to the minister for his answers so far. Just to advise that the member for West Vancouver– Capilano is coming up next. R.

Sultan:I return to one of my perennial topics in health budget estimates: British Columbia’s cochlear implant program at Children’s Hospital and also British Columbia’s adult cochlear implant program at Providence Health Care, St. Paul’s Hospital. I congratulate the minister and the ministry on the excellence of both programs. I declare my own conflict of interest, since I myself am rather hearing impaired — a great advantage in politics, somebody once told me — but unfortunately not a candid- ate for cochlear implants.

Both the adult and the children’s programs are import- ant in restoring full capability to qualifying deaf persons, even though not everybody benefits equally from the pro- cedure. I’m sure the minister and the ministry resist any impulses about the lion’s share of implant resources to one cohort or the other. For the adults, the good news is the promise of a $12 million donation to a new B.C. Rotary club hearing and balance centre at the new St. Paul’s Hospital, announced by the minister. We all celebrate this landmark development that many, many of us have worked on for many years. St.

Paul’s hopes the leverage of this donation will create an institution of international recognition, enhancing its already high reputation. Both our adult and our children’s programs are bud- get-constrained. That’s a familiar message. There are more candidates available than surgical resources can handle. I’m most familiar with St. Paul’s, currently fun- ded for about 46 implants per year. Excluded is bilateral implantation, meaning in both ears, despite strong clin- ical evidence of its effectiveness.

Similarly rejected on fiscal grounds are asymmetrical hearing-loss candidates, characterized by severe hearing loss in only one ear. Data shows that these candidates would do better if bilateral hearing was restored. Since cochlear implantation is a relatively new proced- ure, wait-lists have not been unreasonable. However, as the benefits become more widely known, the expectation is that wait-lists could begin to stretch into one or two years, which would be unfortunate.

My first question, Minister, is: could the minister give us his views on the resource issues and the priority attached to both the adult and the children’s cochlear programs? Hon. A. Dix: We had a good discussion of this last year. I think it shows the commitment of people both at St. Paul’s and at Children’s Hospital that the number of implants actually is higher than the budgeted number in each year and continues to be higher. The member will know that both at Children’s and at St. Paul’s, the cochlear implant was one of the….

It was called non-urgent elective surgery only because we’re defining urgent in a different way, but these are obviously important surgeries. Those were cancelled or delayed on March 16 and then relaunched May 18. He’ll know that since then, cochlear implants at both St. Paul’s and at Children’s Hos- pital have resumed, and that’s good news. [3:20 p.m.] At Children’s, there’s no wait-list for cochlear implant surgeries, and two, as they say, have been performed since surgeries resumed there on May 18.

That’s a significant point, an important point, and I’ d refer him to the extens- ive discussion we had about the children’s side of this in yesterday’s estimates. With respect to the demand for surgery at St. Paul’s, it is true that average wait times were in months in the early part of the last decade — 20, 24 and 25 months — leading into 2016-17. That situation has improved sig- nificantly since then, I should say, in the period before I became Minister of Health and in the period after it, such that we’ve seen an increase in the number of patients receiving the care.

I’ll take his interest in the area and his comments — with respect to, shall we say, other ways that patients can benefit from cochlear implants — to the people of Provid- ence Health Care. Clearly, both on the children’s side and on the adult side — this is approximately a $2.6 million 332 Committee of Supply,

Section C Friday, July 24, 2020

program — given its impact on people’s lives, it has proven that it’s cost-efficient. As we develop our surgical plan and seek to reduce wait times in a number of priority areas, this is one of the areas that we can look at, and I’ll take the member’s comments as representation to do so. R. Sultan:The minister has introduced money into the conversation. So let me follow up on that. The COVID-19 experience is demonstrating that some phases of the cochlear implant preparation may be con- ducted remotely.

As a matter of a fact, I guess this is an illustration that all disasters aren’t totally bad, because this is an example of innovation being prompted by necessity. It may not need face-to-face consultation. “We’re seeing improving triage of patients by telephone” — these are the words of my physician down at St. Paul’s — “and remote viewing of medical imaging. ” Now, that’s an innovation. This would seem to be an encouraging gain in productiv- ity. However, I am told that the current funding system pays only on the basis of a patient face to face with the sur- geon.

Would the ministry consider taking a hard look at the basis of compensation, so that productivity-enhancing remote consultations would not necessarily be discour- aged? Hon. A. Dix: In fact, in this COVID-19 period, there has been a dramatic, almost exponential, increase in the amount of virtual care provided around B.C., including new billing numbers. Its relation to cochlear implants and specialist care is something of interest to us as well.

I think what we’ve seen is not just a cultural change for the health care system but a cultural change for people, many of whom would have balked at the idea of a virtual visit a while ago but are now seeing its utility. It has utility in people’s lives as well. The idea of taking the afternoon off and getting a visit and waiting in a wait- ing room has been replaced for some people by a more convenient and, maybe, appropriate service. That’s not to say there isn’t utility in face-to-face meetings with general practitioners and specialists. I think these productivity gains are real.

They present some challenges — as the member will know, from his economics background — to the health care system in terms of overall costs, potentially. We have to work those things through, but new systems have been set up in this period. They’ve worked quite successfully. I think what we’ve seen is both a transformation of the pop- ulation of practitioners and a transformation in the atti- tudes of patients. That will lead to dramatically increasing use of virtual care in the future. We have more ability to do that. He’ll also know that we’ve seen the addition of the CST system at St.

Paul’s Hospital, following Lions Gate, which has made a real contribution to the use of virtual care and has improved the quality of care at St. Paul’s and other hos- pitals where it has been put into place. R. Sultan:Thank you, Minister. Let me just say…. I think, like virtually all British Columbians, we’re very proud of our health care system. [3:25 p.m.] S. Sullivan:My question is on St. Paul’s Hospital. I note that in 2019 the budget was $1.915 billion but that in 2020 it’s $2.083 billion. This is an increase of about 8½ per- cent.

The entire increase is being funded by the province, and the provincial share will increase from $990 million to $1.15 billion, which is a 17 percent increase. I just wanted to get a confirmation or an assurance from the minister that this project is going ahead as planned and that the targeted completion date is still 2026, within the budget of $2.083 billion. Hon. A. Dix: I get to talk about St. Paul’s. It’s fantastic; my afternoon is complete. As members will know, the St. Paul’s replacement project has been a long time in the making. Certainly, dozens of

Document details

Collection	British Columbia — Debates (Hansard)
Citation	20200724pm CommitteeC n16
Type	hansard
Volume / chapter	20200724pm CommitteeC n16
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	c03c45911675883ddbafc630940258a229221d53

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