Third Session, 42nd Parliament

(2022) OFFICIAL REPORT

OF DEBATES

(HANSARD)

Thursday, October 27, 2022

Afternoon Sitting

Issue No. 241

ISSN 1499-2175

The HTML transcript is provided for informational purposes only.

The PDF transcript remains the official digital version.

CONTENTS

Routine Business

Introductions by Members

Orders of the Day

Second Reading of Bills

Bill 36 — Health Professions and Occupations Act

(continued)

D. Clovechok

I. Paton

D. Ashton

P. Milobar

T. Stone

Hon. A. Dix

Committee of the Whole House

Bill 34 — Opioid Damages and Health Care Costs

Recovery Amendment Act, 2022

Hon. A. Dix

M. de Jong

THURSDAY, OCTOBER 27, 2022

The House met at 1:01 p.m.

[Mr. Speaker in the chair.]

Routine Business

Introductions by Members

Mr. Speaker: Members, I wish to bring to the House’s attention that 12 Legislative

Assembly employees will be recognized at Government House this evening for

their public service, ranging from 25 to 35 years.

These remarkable individuals are Karen Aitken, Karen Armstrong,

Shannon Ash, Brandon Fox, Jennifer Horvath, Julie McClung, Mary McIntosh,

Mary Newell, Kathryn Reine, Polla Savage, Libby Sorenson and Heather

Warren.

Please join me in recognizing them and their years of dedicated

service to this House.

Orders of the Day

Hon. L. Beare: I call continued second reading, Bill 36.

Second Reading of Bills

BILL 36 — HEALTH PROFESSIONS AND

OCCUPATIONS ACT

(continued)

D. Clovechok: I’m glad to be back after being unceremoniously interrupted

because of biological requirements and food needs. We’re glad to be

back.

I was talking, as you recall, about rural health care and the

broader context of the bill in what has been said to be a crumbling

health care system — and keeping that in mind. Through these different

colleges…. Each of the provinces have these colleges. One of the things

that I hope that’s in this bill is a way to work with other ministries

in other provinces.

[J. Tegart in the chair.]

For the record, Madam Speaker, I’d just like to read into the

record a letter from the office of the Minister of Health from Alberta

that I received about transborder health care, and just a few of the

words that he said. I’m not going to read the whole letter

out.

“There is a strong relationship across our Rocky Mountain border for

travel, trade and tourism, and I recognize this is an important matter

for our two provinces. Please be assured that the Alberta government is

committed to providing quality and accessible health care in accordance

with the Canada Health Act.

“Alberta Health Services has continued to provide care to

out-of-province patients requiring emergency procedures, especially

procedures that are not available in their home province. Additionally,

we have continued to accept children from programs where Alberta health

care is the western Canadian referral centre, and adults and children in

cases where transfer conditions would preclude safe and time-sensitive

transfer within their same provinces.

[1:05 p.m.]

“Supporting access to primary care, including physicians,

particularly in the area close to provincial borders in rural Alberta” —

which, of course, is my riding — “is an important priority for the

government of Alberta. Alberta’s government, Alberta Health Services,

recognizes the need to provide health care to those beyond

Alberta.

“Given the concerns that you have raised, and recognizing the

opportunity to build from previous discussions, I’ve asked Alberta

health care officials to connect with their British Columbian

counterparts to re-engage in this important matter. I look forward to

joint efforts, ensuring clear and consistent processes across health

authorities to help residents in our border areas, your constituency,

access the primary care that they need.”

I’m very appreciative of that letter from Minister

Copping.

Again, I hope that inside this act there might be a way to see if

there are any cooperative, collaborative initiatives between the two

provinces. There’s lots of work to do in rural British Columbia, but

there are also lots of opportunities as well.

What we found in rural health care is that it’s not a cookie

cutter. One shoe doesn’t fit all. I know the minister knows that very,

very well. I think also, when dealing with this bill, it’s important to

establish from the beginning that it’s a bill completely to redesign the

Health Professions Act. That’s a big job, and what we’ve got to make

sure happens in that job is — again, there are key performance

indicators, and there are measurement tools: how do we know that this is

going to work?

Now, this is one that was interesting. The Health Professions Act

deals with, currently, 26 regulated health professions, of which 25 are

governed by 15 regulatory colleges. I hope that inside this bill,

there’s a way to explain, outline and measure how these colleges will

not work in silos. I think it’s critically important that they work side

by side, cross-partnership, so that all needs are understood and that

each college understands how they affect other colleges. I’m looking

forward to seeing that in the bill.

These colleges have legal obligations to protect the public

through the regulation of their restraints. At present, the college

reviews all complaints about professionals they regulate, including both

current and former registrants. I think that the director of discipline

— and the creation of that position — is very important. I referenced

that prior, too.

We get a lot of complaints in my constituency offices on a variety

of things, whether it’s how people are treated, the inability to access

service, the ability to access a doctor. I think the director of

discipline having a position that kind of acts as an ombudsman, so to

speak — as I understand it, anyway — might be there.

Of course, on the principles that I alluded to before — I go back

to the UNDRIP position — I think this is critical. We’ve got to find

ways to make sure that our health care system does not discriminate

against anyone or any person. I look forward to seeing what that’s in,

in that act.

Extrajurisdictional practices. Now, I know that some of my

colleagues have already mentioned this in their speeches, and I’m going

to re-mention that, because I think it’s really important. One out of

five people in our province doesn’t have a doctor. Doctors are retiring.

There’s certainly a sense, in our constituents, of: “What do we do now?

We’ve got prescription drugs and….” I know that there was a woman in

Victoria, I believe, that actually took out an ad in the newspaper to

find a doctor. I think it’s really important that we address that

issue.

As many of my colleagues have referenced before, we do ride in

vehicles, and they happen to be taxis. I, too, had an experience with a

gentleman who was incredibly articulate. You could tell how educated he

was. I just straight up asked him. I said: “Give me your story. We’ve

got time to get to the airport. Give me your story.”

[1:10 p.m.]

He was a thoracic surgeon where he had come from. Not only that;

his wife was an anaesthesiologist, and neither one of them could get a

job in this country or in this province. That’s a travesty; we’ve got to

fix that. Whether that goes through the colleges, or how that’s going to

work…. I know that the member for Stikine talked about his experience in

the federal parliament and how nobody was willing to take that on

there.

I’m really hopeful this bill will show how the bill itself is

working with the federal government. I hope the federal government is

involved in this in some way, because this is a Canadian health care

system, and it needs to work that way.

We’ve got people, even Canadian students…. I know that one of my

colleagues referenced that just the other day. We have Canadian students

who are going to Harvard school of medicine. They’re going anywhere in

France and in the U.K.

When they graduate, they can’t get back to Canada. It’s

ridiculous. Guess where they’re going. They’re going to the United

States. We’re losing mental capacity. The brain drain is going into the

United States, where they can make more money. They want to come home,

but they can’t, and that just doesn’t make any sense. I really hope that

Bill 36 will address that component.

One of the things that I think really resonates for me in this

bill…. I hope that, as I say, the credential recognition process and

licensing is addressed in this after six years. But I think one of the

other things that is really important is the impact of our health care

system on public safety.

I just want to talk a little bit, and I know I’m running out of

time, unless the Speaker gives me a little bit more. We’re running out

of time, but I do want to make reference very quickly to some outcomes

because of the system. Hopefully, this will be addressed.

I get emails just about weekly from people who have had really bad

experiences with ambulance care. This one…. A 62-year-old woman with a

severely dislocated hip was on the ground for two hours in the rain,

with people, strangers, just milling around her, in incredible pain —

and two hours before the ambulance arrived.

Another gentleman was working on a split rim. It blew up.

Fractured leg, compound fracture, bleeding and deformity, as well as

penetrating injuries to the arm for metal fragments, and 34 minutes on

the ground before his family transported him. The ambulance never did

show up, ever.

These are things that are affecting British Columbians. These are

my constituents. These are people that I work for, people that hired me,

who are having a bad time with the health care system. We cannot have a

conversation without considering the border challenges occurring,

putting health care staff under increasing pressure.

I really hope in my heart that this bill and the clauses that

we’re going to go through in committee will address all of these things

that I’ve talked about, and we’ll find some solutions.

I appreciate the opportunity.

I. Paton: It’s my pleasure to get up today and speak to Bill 36, the Health

Professions and Occupations Act. It’s been a while since I’ve been able

to get up and speak, since back in the throne era of early 2022. So this

afternoon, I’d like to pay tribute and thank a few people, not only in

my family, but people involved with my family, very involved with the

medical profession in our hospital here in Delta.

Bill 36 attempts to “improve health outcomes and the lives of

British Columbians with respect to their interactions with the health

care system.” That’s a direct quote from government, and many of the

things I’ll be talking about today, including examples of many people

that come into our office and files we have in our office about people

very frustrated with the diagnostic wait times, with access to a general

practitioner, to a family doctor, etc.

As I said, I’d really like to pay tribute to some people in my

family very involved in the health care industry. My mother, Marge, who

turned 95 this summer, graduated as a registered nurse from Royal

Columbian Hospital nursing school in 1948. She carried on for many years

as a nurse. My sister, Glenda, was a registered nurse at Delta Hospital,

and we’re all very proud of our Delta Hospital.

[1:15 p.m.]

My dad, by the same name, was one of the original businessmen —

farmers, local businessman — that said: “We need to have a hospital in

Delta.” He was part of the groundbreaking crew that helped raise money

and moved forward to government to get a hospital built in 1975 in my

hometown of Ladner.

I also want to pay tribute to my wife, Pam, who has gotten

involved with the Delta Hospital Foundation over the years. Proudly, she

just, as of two weeks ago, is the new chair of our Delta Hospital

Foundation. They do tremendous work raising funds for diagnostic

equipment and all the different things we need at our Delta Hospital. Of

course, our hospital gala, which is an annual event, is coming up in

just a few weeks, and the MLA for Delta South, once again, will be the

auctioneer there. Over the years, I think I’ve raised probably close to

$1 million with my auctioneering services for the Delta

Hospital.

We do have lots of involvement with the health care industry in my

family. As far as colleges go, I can even say that at one time, way back

in my university days, or just out of university, I was a member of the

B.C. College of Teachers, and my brother Dave, who’s a veterinarian, is

currently a member of the B.C. College of Veterinarians.

I am glad to have the opportunity today to stand and speak to the

bill before the House, one that significantly impacts our health care

industry at a very critical moment in time. At my office in downtown

Ladner, in the riding of Delta South, probably the number one visit,

phone calls, files, emails that come in to us in our office, to the two

wonderful young ladies that work for me, are health

care–related.

Certainly, people are there all the time, especially,

unfortunately, elderly — knocking on our door, coming in and telling us

the story of how they do not have a family physician. They don’t know

what to do to try and find one. Many, many even younger people have come

in. Their family physician has recently retired, and they just don’t

know what to do to go to find a family physician.

However, being a non-partisan office, we’re more than happy to

speak with these people and try and put them in touch with the Delta

Division of Family Practice and get them on the Fetch Program, get them

in the queue.

I can say that, thankfully, I have a general practitioner, myself,

and I’ll just call him, for now, Dr. Brad. Dr. Brad runs a great

facility, and he’s one of the rare doctors that continues to actually

own a facility, the bricks and mortar, where he has to do renovations

and upkeep of his equipment and fix the roof if it’s leaking and hire

staff. That’s what a lot of doctors now don’t want to do. They want to

come out of medical school and have the nine-to-five job and just simply

work at a walk-in clinic. So kudos to the general practitioners that

still have the bricks-and-mortar offices, that continue to practise in

that way.

I go to my own doctor, Dr. Brad, and on the q.t., I say: “Look, is

there any chance you could take a few more clients? I’ve certainly got

people in my office who would love to move on to find a new GP.”

Unfortunately, it’s usually the same old answer, that they need to get

on the list with the Delta Division of Family Practice.

We know that we’re in the middle of a deadly health care crisis,

and something certainly needs to change in this province. The

legislation before us today does not seek to solve the health care

crisis. In fact, it has been in the works for quite some time and deals

mainly with the regulation of health professionals. That does not

necessarily mean that it won’t have any impact on the system as a whole.

Therefore, we must be extremely careful, as we make changes, to ensure

that we do not exacerbate existing problems.

The goal of the Health Professions and Occupations Act is to

streamline the process and the path of the number of regulatory

colleges. Looking at the bill, I’ve never seen such a thing: 276 pages

in length, over 600 sections. I send out my condolences to some of our

folks that are going to be going through this

section in committee

stage, bill by bill, with over 600 sections to the bill.

Now, as already alluded to, this legislation has been a work in

progress for quite a long time — multiple years, actually. It is based

on the recommendations of the steering committee as co-chaired by the

MLA for Kelowna–Lake Country, the Leader of the Third Party and, of

course, the Minister of Health.

[1:20 p.m.]

The committee’s work began prior to the pandemic and before our

system was showing the explicit outward signs of crisis that we see

right now. The main purpose of the committee was to make a series of

recommendations to modernize the health profession regulatory

framework.

After a long period of discussion and consultation, significant

recommendations were made by the committee to include cultural safety

and humility, improve governance of regulatory college bans and

establish an independent discipline process while also revising the

complaints process with the aim to make it more transparent and focused

on patient safety. I read from the health regulations in B.C.: “The

regulation of health professionals in British Columbia enables patients

and clients to have confidence in receiving care from regulated

practitioners who have the appropriate training and skills to provide

qualified, safe and ethical care.”

Regulatory colleges protect the public through regulation of their

registrants, and they do this by eight different things: “Determining

entry-to-practice requirements, recognizing education programs, setting

standards of practice, maintaining a searchable public register of

registrants, administering quality assurance programs, administering

annual registration renewal of registrants, managing a public complaints

and professional discipline process and,” No. 8, “conducting other

regulatory practices.”

The bill as written includes many of these changes. Its main

intent is to protect the public and streamline the way we currently

regulate health professions, both goals we are in support of. Having an

oversight body will promote accountability, transparency and consistency

across all different colleges. We agree that these are very important

matters to consider.

However, we also have to recognize that our health care system

looks very different today than it did when these recommendations were

first made. Every discussion that we have about this legislation over

the next few days and weeks, both here in second reading and later in

committee, must be done with the broader context of our now crumbling

health care system in mind.

I’d like to now point out a few things about our crumbling health

care system in British Columbia. One million British Columbians

wait-listed to see specialists. Worst walk-in clinic wait times in the

country. Hundreds of thousands unable to get timely medical imaging. One

in five people in this province are without a family doctor. Hospitals

are in chaos and the ERs closed across the province. I have a sheet, I

think eight or ten pages long, of examples of ERs that have been closed

in the last ten months in this province. People are dying after two days

on the stretcher in waiting rooms, and ambulance delays that are costing

people their lives.

I’d like to just quickly point out an example of one million

British Columbians waiting to see specialists, an example very close to

my office in Ladner. My own constituency assistant, who has a long-time

family doctor, has an undiagnosed pain condition. She has waited for six

months to see a peripheral neurologist, another four months to see a

central neurologist, another five months to see a rheumatologist and

another three months to see an endocrinologist. After another month to

see a specialist at the Centre for Disease Control, another three months

just for an electromyography, EMG test. These wait lines are certainly

too long.

Hundreds of thousands are unable to get timely medical imaging.

Relating to Bill 36, I’d also like to read out an example of people that

have come into my office. A pair of married seniors entered my office

this week who are concerned about the wait times to find a doctor. She

has Parkinson’s disease, and she is concerned that her doctor has

retired and she cannot find a replacement.

The ongoing management and specialist referrals she requires to

manage her condition require a general practitioner to refer her to

them, yet she is unable to get referrals for diagnostic scans, blood

work and other specialty appointments in order for her to manage her

Parkinson’s and live with dignity and care. They are active members of

the community, volunteering with various organizations in the community.

They certainly deserve better.

[1:25 p.m.]

Another example here, if I could. One in five people in this

province without a family doctor. A constituent contacted me, a resident

of Ladner, to express their deep frustration and concern about the

ongoing shortage of family doctors in our community. He moved to B.C.

seven years ago and still has yet to secure a family doctor. He recently

attempted to consult with a physician via telehealth. After he ordered

and received the blood work, the telehealth doctor recommended that the

constituent see his family doctor, because his concerns warranted a

physical exam.

What type of system is this where someone can’t find a doctor,

goes to a telehealth appointment, only to say that he needs a family

doctor to check the results of the telehealth appointment?

Another example of the exact same thing, very much relating to

Bill 36. An 85-year-old constituent came in who does not have a computer

and was confused on how to sign up to get on a wait-list for a family

doctor. She has gone to a number of medical clinics in Tsawwassen to

inquire about if a doctor is taking new patients, and she has been

repeatedly told that she needs to sign up online, but this elderly lady

doesn’t have a computer.

Once online, she became very confused, when she found a computer,

with where to sign up, given that there are so many portals and

non-profits offering to match people to doctors. She could not access

the Delta Division of Family Practice website in order to get on a

wait-list, and she didn’t know about the Fetch B.C. program, which also

offers matching services. Given South Delta has such a high number of

seniors, she was upset that the system is so hard for seniors to access

and how complicated it is.

As I have alluded to already, we are supportive of many of the

goals and efforts in this bill, but it is long and it is complex, and it

needs to see serious scrutiny before we can fully be supportive of Bill

It’s important to establish from the beginning that this bill is a

complete redesign of the Health Professions Act. The Health Professions

Act deals with the currently 26 regulated health professions, of which

25 are governed by 15 regulatory colleges. The number of regular

colleges are many — very, very many. The College of Nurses, the college

of dentists, dental assistants, hygienists, surgeons, therapists and

massage therapists, only to name a few.

Having dealt with a gentleman involved with the B.C. lab

technicians…. He’s come to me on several occasions, hoping that there

will be a college created to cover the regulation of lab technicians,

because, of course, lab technicians are a very, very important part of

what we do. They’re the ones that take the samples, take our blood tests

and send those in. It’s very important that we have them properly

trained and updated with education to handle all the lab results that we

look for when we go for testing.

These colleges have the legal obligation to protect the public

through the regulation of their registrants. At present, colleges review

all complaints about the professionals they regulate, including both

current and former registrants.

Bill 36 significantly expands on the previous duties of a college

and establishes a series of guiding principles that will be applied to

all under the act. A college’s office of the superintendent, director of

discipline, etc. These principles include acting in accordance with the

United Nations declaration on the rights of Indigenous people. This is

an important piece of legislation, and something I know that my

colleagues and I will discuss in greater detail later in

debate.

Getting back to my comments a moment ago about the different

colleges in this province, it’s very interesting to see that the College

of Nurses and Midwives, oral health professions, social workers,

chiropractors, dietitians, massage therapists, the College of

Naturopathic Physicians, the College of Occupational Therapists,

opticians, optometrists, pharmacists, physical therapists, physicians

and surgeons, psychologists, speech and hearing health professionals and

traditional Chinese medicine practitioners are all part of the college

program.

[1:30 p.m.]

Other principles include procedural fairness, respect for privacy,

promotion of holistic health care system and identifying and removing

barriers for extrajurisdictional practitioners. The latter speaks to

those who are internationally trained and educated. The bill also seeks

to make a clear path for an unregulated health profession to apply and

receive designation.

Bill 36 would create a new office of the superintendent as an

oversight body. The superintendent would be appointed by cabinet and

would have a number of duties, including the ability to conduct an

assessment of the unregulated health profession or occupation if

regulation is needed or different regulation is needed of an already

designated profession or occupation, if required by the minister or the

superintendent determines an assessment would be in the public interest

— and would be required to notify the minister, if so. The bill sets

this process for how an assessment would be conducted; however, much of

the parameters, scope, conduct, timeline, etc. are left to the minister

to decide.

As per

section 440, the superintendent may require colleges to pay

a general admission fee, to be set by the superintendent, subject to

regulations. This would pass on the cost of funding the superintendent’s

office to the regulators. While the office of the superintendent is an

independent body, there is a provision in this bill that requires the

superintendent to comply with any orders the minister makes.

In addition to creating the office of the superintendent, this

bill also creates a new independent discipline tribunal. The tribunal

brings discipline out from the jurisdiction of the regulatory colleges

to this independent body; however, the investigation stage remains at

the college.

It’s also important to highlight the impacts this bill could have

on internationally trained and educated health professionals, a large

part of Bill 36. This would appear to respond to the minister’s mandate

letter that required him to improve “the province’s credential

recognition process and licensing.” The expediting of approvals for

internationally trained health professionals is something that the

official opposition has been calling for, for months. So if this bill

can quicken the process, it will certainly be beneficial.

We need our doctors, the people sitting within those colleges, to

be able to verify the talents and skills and the training that somebody

has when coming into British Columbia will meet our standards and, if

not, how they can achieve those standards now that they are in the

country.

We have all these demands and needs within our health care system.

We know we need more workers. We have an available talent pool that have

actually immigrated now, and there’s a barrier that remains. Some of the

colleges are sending somebody who is a qualified surgeon in their home

country, asking them to go back to medical school in order to qualify to

be a general practitioner in B.C. In the meantime, how does a new

immigrant in Canada afford going back to college, back to medical

school, while they’re just trying to simply make ends meet and become a

physician in this province?

I’d like to read one more story from walk-ins to my office in

Ladner that very much so relates to Bill 36. A mother entered my office

requesting information about how to get her son back to Canada to

practice medicine, given the shortage of doctors here in British

Columbia. Her son is a Canadian but trained in Australia due to the lack

of physician training spots and ridiculously competitive nature of

medical school schools in British Columbia. He is now a fully trained

and practising doctor in Perth, Australia, who would like to come

home.

But the arduous paperwork and lottery-like system for converting

licences is hard and complicated. They are having trouble understanding

the process and the paperwork he needs to do to convert his licence, and

they are wondering why this is so difficult here in British

Columbia.

As we go through this bill, we also need to keep in mind that it

is largely enabling legislation. Much of what this bill seeks to

accomplish is not done in the text of the legislation but through

regulation at a later date, at the discretion of the minister. This

allows government to be more nimble in situations where flexibility is

necessary, but it also raises questions.

[1:35 p.m.]

While some regulation-making powers make sense, it means that

there is still so much we don’t know about what this bill will do and

how it will impact our health care system. As such, we will be examining

the bill closely and thoroughly in committee, particularly as to what

this will look like in practice with our health care system in its

current state.

We cannot forget that we are still in the middle of a crisis. We

are dealing with hospital closures in every corner of the province,

difficulties with specialist access, nearly one million British

Columbians on waiting lists, long wait times for access to medical

imaging, paramedics under significant stress, the ambulance delays, and

one in five people in this province without a family doctor.

I believe the minister understands this situation. I’ve dealt with

this group of young mothers in my riding with an illness or

configuration that I, frankly, was not very familiar with. But it’s

rather common, and it’s called club foot, in newly born children. We

have constituents in South Delta whose children suffer from club foot

and hip dysplasia. They have been sending letters to the Ministry of

Health and the hon. Health Minister in efforts to reduce wait times for

children needing orthopedic surgery in Fraser Health.

These young mothers have been in my office. I’ve sat with them,

and they’ve brought their children and showed me the incredible work and

braces and different things they put on these children’s feet to correct

what’s called club foot in newborns.

Currently there is only one pediatric orthopedic surgeon for all

of Fraser Health to deal with club foot in children, according to its

own website, which serves 1.9 million people in Fraser Health. Parents

are concerned that the new surgeon, who recently replaced the retired

elderly Dr. Pirani, is only working at 50 percent capacity, even though

they were hired to work a full-time schedule. Dr. Pirani has expressed

concern over this as well.

There has been no planning or forward movement on the

comprehensive pediatric program, promised by the NDP government, in the

nearly seven months since she was hired. Children in South Delta have

been waiting over a year and a half for surgeries. According to parents

in my riding, the wait-list for surgery is over 200 children

long.

These children are in pain and unable to participate in childhood

activities while they wait for surgery for their club foot issues. These

parents have been talking to Fraser Health for over a year and still no

answers from the Ministry of Health. With only one letter back in March

from the Minister of Health, with unfulfilled promises of developing the

pediatric surgical program and services, we are actually seeing reduced

capacity and longer wait times than ever.

One other quick example that certainly fits in with the sections

and pages of Bill 36 — another example, if you will give me that

opportunity: a 38-year-old American resident, who is here on a Canadian

work visa for a professional white-collar engineering job at the port of

Delta cannot find a doctor — shocker — and didn’t know how to sign up

for a doctor. Once we gave him the information — this is from my staff

at my office in Ladner — he said that the wait-list for a doctor was

going to be months.

He has chronic sciatica in his back, along with a torn muscle in

his leg that requires constant care. He has been going to Delta Hospital

emergency to be able to get a referral by a doctor for Botox injections

into his back and physiotherapy for his leg, but he is wondering why

it’s taking so long to get a family doctor.

He half-joked that our health care system is worse than it is in

Florida, where he’s from. He is in a very specialized industry of marine

engineering and is often asked by other professionals in the United

States if they should try to come up and work in Canada. He has recently

advised them not to bother, due to the poor state of our health care

system.

We are dealing with hospital closures in every corner of the

province, difficulties with specialist access and nearly one million

British Columbians on waiting lists. Long wait times to access medical

imaging, paramedics under significant stress and ambulance delays are a

common occurrence even in my riding of Delta South. One in five people

in this province is without a family doctor. On top of that, we recently

saw the announcement of a fairly lacklustre health HR strategy that was

missing important metrics and timelines.

[1:40 p.m.]

This legislation before us today is simply one piece in the issue

of patient safety. It is not, by any means, going to cure what currently

ails our health care system. Although, to be fair to the minister, I

don’t think he’s presented it as such. However, as I have mentioned

numerous times, we cannot have a conversation about health without

considering the broader challenges currently putting health care staff

under increasing pressure and patients at greater and serious

risk.

As I close, I want to say…. As mentioned by some of my colleagues,

as we went through the pandemic in the last 2½ years, I want a shout-out

to all the people that worked in the health care industry in my riding

of Delta South, the wonderful doctors and nurses and staff that all

worked at our wonderful Delta Hospital — by the way, the only hospital

in British, Columbia, I believe, to this day, that does not charge for

parking. We’re so proud of that in Delta, at our Delta Hospital — free

parking for anybody that comes.

A wonderful thank you to everybody that got us through this

pandemic at Delta Hospital, all our local physicians in Delta, Ladner,

Tsawwassen, North Delta. Like many ridings, we had so many wonderful

nights, during the pandemic, where the fire department, the police

department, the ambulances….

We all got in our pickup trucks and we went around that hospital

every night at 7 p.m., banging our pots and pans to say thank you to all

the health care workers in my riding.

D. Ashton: It’s my honour and my pleasure today to stand up and talk about

Bill 36, the Health Professions and Occupations Act.

Before I do speak, I, too, just want to be able to thank not only

the people that I have the great opportunity to be associated with in

the riding that I represent, which is from Peachland and surrounding

area, Summerland and surrounding area, Penticton and surrounding area,

and Naramata and surrounding area — a wonderful group of people that

open their arms at all times of the year to welcome the tourists that

come to our area, who make our hospital quite busy at some times, quite

often during the summer. It’s a wonderful place to live and a wonderful

place to have the opportunity to be an MLA and to represent that

particular area.

I also would like to thank, from the bottom of my heart, the

physicians, the nurses, all the hospital staff and any of those that are

associated with looking after people that have had to attend the

hospital or are having to attend the hospital — i.e., ambulance drivers

and paramedics. They do an incredible job in our area, an absolutely

incredible job.

You can’t say enough. You cannot say enough about the challenges

that they are facing themselves these days, that the health care system

is facing, but they are there all the time. Yes, we know that there are

waits and there are unfortunate incidents, some of which I’ll bring up

to people’s attention today, that transpire, but these individuals just

do an incredibly remarkable job for the people of Penticton and area,

the regional district of Okanagan-Similkameen and then, plus, the

Peachland area.

The Health Minister…. I’m probably not supposed to say this, but

the Health Minister was here a few minutes ago. I wanted to thank him

personally. I wanted to thank his staff, because, in Penticton, we’ve

just been awarded a $22 million oncology addition to the Penticton

Regional Hospital. That is going to make an awful huge difference to the

people of the regional district of Okanagan-Similkameen, which is the

catchment area, the draw area for Penticton Regional Hospital.

Hopefully, so many of them are not going to have to travel to Kelowna

for treatment.

[1:45 p.m.]

One other thing, while I think of it, in case I forget. It was

mentioned by many of my peers today. There are 645 sections in Bill 36.

I wish there were 646, and the 646th one would be that those of us that

live outside of the Lower Mainland didn’t have to pay 40 percent of the

ongoing costs for new construction or for hospitals.

You know, it doesn’t sound much. You can say it quick, and there

are all kinds of explanations that have been given to me over the years

of why this is happening.

But I’ll tell you. Penticton got a brand new hospital. The

minister was up there to open the first part of it. Just over $300

million — I think it was $330, if I remember correctly. Approximately

$140 million — I’ll say that real quick again; $140 million — was raised

by the people of the regional district of Okanagan-Similkameen for that

new hospital.

Nobody — nobody — wants to deny anybody the opportunity of having

the best medical care and the best facilities in it. But a lot of us are

pretty envious about the people in the Lower Mainland who get their

hospitals paid for. I would just hope that at some point in time, with

another bill that might come forward, that government will say, “We’re

going to put everybody on the same even keel throughout the entire

province,” because it would make a difference.

The other part, and probably one of the most important parts of

that, is the thousands of people and families that have made

contributions. I’m only using Penticton Regional Hospital as an example.

But there are many hospitals outside of the Lower Mainland that have

these people that have made massive contributions towards hospitals in

their specific areas, to make a difference, to help buy that equipment

that just isn’t in the budget of the government at that point in time,

or to help provide transportation costs or to help provide better rooms

and make bright and airy hospital corridors. They’ve done an exemplary

job.

Then you get individuals…. There’s a gentleman who never ever

wanted to have his name mentioned. But at the end of his life, he

dedicated a massive amount of money — over $8 million — to the Penticton

Regional Hospital. It’s called the David Kampe Tower, the new addition

to the hospital. Along with that donation in the latter part of his

life…. And I was actually going to phone today and reconfirm it. It was

either a CAT scanner or MRI scanner, in the last day of his life, that

he donated to the Penticton Hospital. It made a huge

difference.

We’ve heard the Minister of Health talk about the additional MRIs

and CAT scans that are being done. Here’s a gentleman that stepped out

of the boundaries of government and paid for one himself so that the

people of that area could have that.

Bill 36. Like I said, if there could have been one more addition

or another bill in the future, it would make a big difference. Yes,

those people are still going to be there. Those incredible volunteers at

the hospital, those incredible contributors to the hospitals that make

those donations — usually at the loss of a loved one or after the

wonderful care and compassion that they got while in the hospital — and

they turn around and make a donation. That makes a big

difference.

So thank you on that, hon. Speaker, for allowing that little bit

of latitude. But I think it’s very important that the people of British

Columbia hear that it isn’t an even keel all across the province. I just

wish the minister was still in in the room. But if his staff are

listening, and I’m quite sure that they are, please pass along not only

my thanks but all the thanks of the Okanagan regional district and

Similkameen areas for the addition of that new oncology centre. It’s

going to make a big difference in our area.

Bill 36. I’m just going to go down really quickly some of the

things that the Health Professions and Occupations Act does. Then I’m

just going to jump back on it and some of the explanations that we on

this side of the House…. And as the previous speaker said, some of the

information that has come to us over our tenure of being elected — some

of the issues that are being faced by the citizens that we represent. I

will start, just quickly, and go through these.

[1:50 p.m.]

Bill 36 gives regulatory powers. These are broad regulatory-making

powers affecting the designation of the assessments of health

professions and occupations, including the criteria to be used when

deciding whether a health profession or an occupation should be

regulated and what regulatory model should be used and the powers and

duties of the health occupation director when governing a designated

occupation. Big words for big oversight. I think it’s incredibly

important that is there.

There are further regulation-making powers regarding hearings that

are conducted by a disciplinary panel and a director of discipline;

regulatory complaints, restorative processes, monetary penalties; as

well as setting the rates and the tariffs, and so forth, to recover

costs or expenses.

Supporting the programs of the administrators, of the regulators.

Broadly defined in general matters, restructuring of the regulators, the

appointment of disciplinary panels and the superintendent’s office and

matters related to that for setting the fees and application, etc.

Hopefully, it never happens — going to court. But see, there are just

some of the regulatory powers that are going to be brought forward in

this bill.

Under it are also mandatory immunizations for those…. Under

part

3, division 3,

section 49(3)(f), a board may make a bylaw “respecting

mandatory vaccinations, required under the bylaws, against transmittable

illnesses.” This

section provides a college with the clear authority and

the power to do so, so that they ensure that those working through the

college are vaccinated.

Again, this is a part of the umbrella of oversight. There will be

those that have the opportunity, as we’ve all had in our offices, to

speak to what they feel is right or wrong. This now is putting it right

into the colleges, and the colleges are going to have to make those

decisions.

Public health emergencies. The provisions in

part 7 regarding

public health emergencies and emergency orders, specifically the

duration of emergency orders, the end dates and the consultations

required for emergency orders…. This will require further canvassing at

the committee stage.

I would like to thank all the individuals that were involved in

the creation and the oversight of this bill, through the health portion

of it, the members of this House. I would especially like to thank the

member from — I’m going to catch myself here — Kelowna, the north part

of Kelowna, for taking this on over the last period of time, also, now,

the…

Interjection.

D. Ashton: Kelowna–Lake Country. Thank you very much.

…very diligent and very hard-working member for Prince

George–Valemount.

There’s a lot to go through on this. We all know…. During

committee stage, there are going to be a lot of questions. I know that

the team that’s involved in this on our side of the House is going to be

diligent and ensure that all the parts of Bill 36 are as they should be

as this goes forward for the passing of it.

Licensee duties in the bill. Among the duties established in this

bill, there’s a requirement for a designated health profession licensee

to practise ethically, which includes a requirement for a licensee to

practise a designated health profession in an ethical manner and in

accordance with ethical standards, as well as for a board to make the

bylaws respecting the ethical standards.

The latter includes a requirement for the board with respect the

providing of false or misleading information to patients or the public.

It appears to be the response to issues, during the pandemic, in which

health professions spread false or misleading information to patients or

the public regarding vaccine misinformation, in particular.

There is no corresponding duty under the licensees of a designated

health occupation. There are now duties to practise in accordance with

the principles of protecting the public from harm and discrimination, to

take anti-discrimination measures, and so forth. This is common through

the bill and probably long in oversight and should be part and parcel of

what transpires.

There is an independent disciplinary tribunal in here. Current

discipline matters are under the jurisdiction of the regulatory

colleges. This legislation introduces a new discipline process separate

from the regulatory colleges. However, the investigation stage will

remain with the colleges. That was recommended by the steering

committee.

[1:55 p.m.]

A discipline tribunal would be established with the

superintendent’s office and would include the director of discipline and

disciplinary panel members. The director of discipline may be appointed

by the minister, and they must be a lawyer currently or formerly in

British Columbia or elsewhere, in another province. So they are looking

at having somebody that has the legal experience to be able to conduct

these disciplinary actions.

The director of discipline may also retain experts outside of the

health authority, I’m assuming, and is responsible for selecting

tribunal members with specific and diverse expertise and the standards

to be published on it. Again, this just gives that broad oversight, and

it gives fairness and equity, the way I look at it. I think that’s

incredibly important.

There are going to be changes to the board appointment process.

Under the current act, boards are set up…. Under this bill, one of the

superintendent’s office’s purposes is “to develop and implement a

merit-based selection process for the appointment of members to boards

of regulatory colleges.” I think that’s very important.

Ultimately, it’s the minister who will make the board

appointments. The superintendent will make the recommendations. I just

hope, and I say this with the utmost respect, that it is non-political.

I hope that it is a broad base and it takes a look for the best people

to go in there, no matter who’s in government.

The bill also establishes an oversight body. The office of

superintendent of health professions and occupational oversight there

consists of the superintendent, a disciplinary tribunal and other

employees as required. The superintendent is to be appointed by cabinet.

The purpose…. Again, I just hope that the best person, the most

qualified person, is picked. That’s what we want in these

functions.

The purposes of the office are outlined in

section 435. They

include the providing of advice, recommendations to the minister on the

administration and the amendments to this act and the regulations; the

performance improvement of the regulators and other matters as requested

by the minister; to promote awareness and adherence to the guiding

principles, to develop guidelines for the regulatory college board’s

appointments and to promote regulatory consistency and to report on

regulatory performance; and make recommendations for improvements, to

publish information and records that are deemed to be of public

interest; and other duties as set by the minister.

Again, I think that’s an important part of it. If there are

issues, very unfortunate issues, with somebody in one of these colleges

that is not conducting themselves in the proper way, I really think the

public needs to know. I think it’s incredibly important that that does

come forward under this bill.

Being an avid motorcyclist and driving around on a big black

motorcycle, it’s always the 1 percenters that give us a bad name, and

the same thing in here. It’s always that little, tiny, tiny fraction

that, unfortunately, people dwell on that does give some of the people

in these colleges and in these hospitals…. It’s not fair that they get

tarred and feathered by the actions of an individual, which is not the

way it should be. So I really, really hope that as this is set up and

set up properly, there can be public disclosure on this, and they can

rectify the situations as quickly as possible.

As we all know, during the pandemic, our health care was

challenged. It was challenged because, as we’ve heard here today, of

circumstances where doctors from other countries, other areas in the

country, that want to come in to British Columbia have a lot of hoops to

drill through. I hope Bill 36 expediates that process.

The previous speaker — actually, the two previous speakers —

talked about specific instances, and I think every MLA in here has come

across that, or someone has come to them and said: “Listen, I’ve been a

practising physician for this many years. When I come to British

Columbia, I have to go through the board, and the board doesn’t make a

decision quickly.”

[2:00 p.m.]

It can take months and months, because, apparently, they only sit

several times or once a quarter. I’m not exactly sure of the time, but

they don’t sit all the time. I would hope that would be looked at,

because British Columbia is a wonderful place to live. British Columbia

has a growing population, and we need more health care

professionals.

I hope this bill will address that so that it makes it a little

bit easier for people to get into the province and practise what they

probably dedicated their life to, and bring their experiences into a

working facility here in the province.

[S. Chandra Herbert in the chair.]

Just a quick story. The minister is back in, and I hope he will

hear my comments from the very thankful people of Penticton and the

regional district area for that wonderful new oncology

centre.

Minister, thank you.

We’ve all probably had experiences, but…. I went to school in

Summerland, and a lot of my good friends are from Penticton, about seven

miles south. One of them was kind of like me, didn’t quite know what he

wanted to do right away. He ended up finally going to medical school,

but it was in Grenada. He became a doctor in Grenada, with a bit of a

break in the interim, when the United States went into Grenada because

of some issues. He had to take a pause in his medical training

there.

I’m dating myself, but he couldn’t come back to British Columbia

to practise without — long and arduous — literally going back to medical

school again. That is funny because he was always a brilliant kid, still

is a brilliant kid. He ended up in Florida. You can look him up. I won’t

mention his name here, but he is one of the top pediatric surgeons in

Florida.

We, British Columbia, lost out. There was an opportunity. I just

use that gentleman as an example. There could have been something maybe

a little bit more. I know he wanted to come home. His family is still in

Penticton, and he would have loved to come back. Once you get settled

and have a wife and have a family and have a big practice and that, you

don’t pick up your roots and move on.

I just hope that through the hard work of all the people that have

probably spent several years bringing this Bill 36 forward, they can

take a look at this and they can have some oversight on some of these

colleges and some of these things that could make a difference for us in

the future.

I touched on a lot of the areas that this bill has. It is a very,

very thick bill. Every word, literally, in each one of these sections is

going to have to be looked at. I trust the people that have composed

this bill, but that secondary set of eyes that comes from the opposition

during committee stage….

If there are issues that are discussed during the committee stage

and are relevant issues, I sure hope that the government will take a

second look at some of these, if they do come forward, and just think

that we’re doing this and we’re acting in the best interests of all the

people of British Columbia.

I mentioned a little bit earlier…. It’s the 1 percenters

sometimes. Unfortunately, there have been a couple of incidents as of

late in Summerland. The biggest one for Summerland, and most recently,

was the closure of our lab. The lab did open. Again, I would like to

thank the minister. I know that not only I brought it to him, but there

was some accommodation made through Interior Health where, if I remember

correctly, they were able to actually move employees around so that they

could open it on a part-time basis.

[2:05 p.m.]

But it was very difficult for a lot of the people in Summerland.

Summerland has a bus that goes down in the morning and comes back late

in the afternoon, so for people to make their appointments, it was

difficult to spend a whole day. A lot of people don’t drive. The average

age in Penticton now, if I remember correctly, is 64, and I’m going to

have to give Summerland a couple more years on that.

Again, I hope that some of this will be covered as we go forward.

And again, my compliments to those in Interior Health that were active

in trying to get the lab up and running again, and also to the minister

for — I’m not going to say intervening — facilitating that.

Unfortunately, we had another terrible incident in Penticton

Hospital just recently, in the last couple of weeks. It involved the

psychiatric ward. I hope, through Interior Health and through the

ministry…. Again, I’m going to hope that this bill will cover some of

this. A person lost his life in there, self-inflicted. It caused havoc

inside that psychiatric ward.

I really hope there’s going to be some oversight, because four

years before that, a psychiatrist, who was an orchardist also…. I knew

him quite well. The gentleman is actually here in Victoria now. He

couldn’t work anymore because of an unfortunate incident that happened,

for protection. People do need protection while in the hospital. That

includes doctors and nurses and hospital staff. We just have to ensure

that there will be oversight on that.

As we go forward with this bill, I really think that it needs to

be said that the opposition members…. I know that we’re supportive of

changes. I know that we’re going to look at it literally every minute. I

know that there’s going to be an incredible amount of hard work through

this in this committee stage that’s coming up.

I just hope — through yourself, Mr. Speaker, and through Madam

Speaker and anybody else that sits in the esteemed chair — that there

will be the opportunity for some very, very good discussion in this. I

know nothing is perfect, and I hope that the ministry and the Health

Minister and those involved in writing Bill 36 will listen to what is

being brought forward by the opposition and some of their

questions.

One of the things, too, that I think is incredibly important with

this bill is the indoctrination of the principles to include an

accordance with the United Nations declaration on the rights of

Indigenous peoples. We all know it as UNDRIP. It’s a very important

piece of legislation, and I know that my colleagues are going to want to

ensure that all the sections that relate to that….

Yesterday we had a wonderful presentation by members on another

bill, from the surrounding area of the lands…. The original occupiers of

the land and their representatives were here. We heard long and hard and

straight from them about some of the issues that another bill is

addressing, but it is going to be very important that Bill 36 does

address a lot of the issues that we, unanimously in this House, passed

underneath the UNDRIP. I think it’s incredibly important and long

overdue.

I know that there’s an awful lot…. You yourself, Mr. Speaker, have

heard a lot of it — and again, those that have been in the esteemed

chair. But for everybody on this side of the House literally to stand up

and to talk about this, you know that there are some concerns and there

are some things that are going to have to be brought forward and have to

be discussed.

For those in the public, this is a very thick bill. It’s going to

be something that we’re going to have to go through literally word by

word. So I’m hoping that there will be the flexibility of individuals

like yourself and, also, the ministry and staff to maybe hear some good

ideas on our side of the House that are probably going to be brought

forward.

[2:10 p.m.]

To go back and to close, out of all the jobs today and the

professions today that people partake in, probably one of the toughest

is to be a health care provider. People have got shorter and shorter,

and they see where things on TV are fictitiously shown how quick you can

get served when you come running into a hospital and that. We know there

are lineups, and we know you get triaged as you come into a hospital,

and those that need care quicker are put forward. But unfortunately, due

to some of the circumstances because of changes in health care and

changes how doctors/physicians want to live, how nurses and other

practitioners….

Their lifestyles have changed. We don’t have doctors coming to our

homes anymore. I’m old enough to remember when the doctor came. If my

dad was sick or my kid sisters were sick or even if I was sick, the

doctor would stop by on his way home. In his little black bag, he

usually had some pills for you. That’s all changed.

I can’t say enough about those individuals that work in the

hospital. I know they’re challenged. I know there are challenges for

government, but we are all collectively going to have to work together

to make it better for all the citizens of British Columbia, and I say

collectively.

We’re going to have to look at different ways of getting people

educated and into the system, getting people wanting to get into the

system, maybe starting earlier in the school system and ensuring that

kids want to take a direction into health care. My son graduated with a

degree of biology and is still flipping around if he’s going to go into

health care or not. I hope he does, but that will be his

decision.

Again, thank you for the opportunity today. Thank you to everybody

for hearing me out. It’s an incredibly important bill. It’s incredibly

important to the people of British Columbia. We can never forget those

are the people that we are here to serve, and we are here to serve as

the best of our ability.

P. Milobar: I rise today to speak on the Health Professions and Occupations

Act bill.

It’s important. We have 12 days of debate left after today in this

chamber. We have the health professions overhaul, a 645-page bill. We

have incredible, important work to do around….

Interjection.

P. Milobar: Clauses, sections. Clauses, soon to be sections.

It’s serious. Six hundred and forty-five….

Interjection.

P. Milobar: They’re actually clauses until they’re passed — to the minister. I

wouldn’t want to be offside with the Chair right at the beginning of my

comments.

We have a 645-clause bill that will totally restructure the

colleges and the professional services and people that work in those

professions. It’s going to take a lot of time to actually thoroughly

canvass and question and probe and make sure everyone understands what’s

in that bill, because future court cases, future challenges and future

rural challenges will all be based on the government’s intention and

their explanation of the intention of that bill, much like what we saw

when UNDRIP came forward in this House. UNDRIP is in this bill as

well.

Layer that with the bill for Indigenous child welfare changes —

very important, very critically important changes that are needed. But

again, very serious questions that need to be asked. An oil and gas

regulation bill that will change the functions of the regulators on

industry. That’s very important and top of mind when we think of climate

change and things of that.

We have 12 days of debate. But no, we don’t have 12 days of debate

anymore. We have eight days, because about an hour ago, the government

decided to remove a third of the days’ worth of debate to do the

people’s business in this House, unilaterally, so that the incoming

Premier can have a week-long coronation party before he gets sworn in on

a Friday.

It’s quite shocking when I look at Bill 36 and I think of the

critical work that needs to get done on this bill and the bill that will

be coming up after this, the opioid bill, and the critical work that

needs to get done on that.

[2:15 p.m.]

Instead of debating and thoroughly being able to dive into Bill 36

and give it the proper due that the public deserves to have, the proper

light the public deserves to have shone on this, we have the most

secretive government in Canada deciding to remove a third of the days of

debate in this Legislature, unilaterally, with a two-line press release,

for no apparent reason.

The swearing-in of the new Premier is going to be on a Friday.

Last I checked, this House does not sit on a Friday. We didn’t need to

change a debate day for that to happen. Why do we not have the Monday,

the Tuesday, the Wednesday or the Thursday of that week to be able to

discuss Bill 36 in this chamber?

King Charles isn’t going to have that long of a coronation

process. The new Premier of Alberta didn’t have that long of a process.

The new Prime Minister in Britain — they figured that out in three days.

He was sworn in and standing up in their Parliament taking questions.

But no, no, no.

Bill 36 — that is going to require a lot of time. I know people at

home are probably thinking: well, then, why don’t I just sit down and

get to the questions? That’s not quite how this place works. The

questions will start on Monday. That’s the earliest they could start. We

do have some other work to get at before we get to this. But it’s

shocking to me that time and again….

The arrogance that is being exhibited by this government, the

arrogance towards the health professionals that are impacted by this

bill, who will not have the benefit of proper questions put to the

government by the opposition to get those answers on the record so that

they and their colleges and the health professionals within those

colleges know exactly what to expect from a bill is shocking. It does

matter.

B.C. Housing is a complete train wreck right now. B.C. Housing is

so bad that the handpicked, appointed board by this government had to be

fired. I know people at home are probably thinking: “What does that have

to do with the health professionals bill?” It has a lot to do with it

because ministers handpicked that B.C. Housing board.

This bill has provisions in it that enable the minister to

handpick members of the boards. We saw how that has played out with B.C.

Housing. We saw just how badly that group has done with the housing

file, where we only have 6 percent of a ten-year plan delivered after

six years, despite billions of dollars going into it. Those dollars are

much less than what we see in the health care system.

Again, we won’t have the requisite, needed time to properly dive

into this bill and find out exactly what this minister has in mind for

those types of appointments and the timelines associated with those

types of appointments, because the government has unilaterally decided

to remove one-third of debate time out of the calendar. People can say:

“Well, you didn’t used to have a fall session all the time either.”

They’re absolutely right. We didn’t. That’s the government’s purview.

But once it’s actually in the calendar, once you’ve actually committed

to those weeks….

To remove a week in the middle of it, too…. It’s not even like the

last week, where they’ve just said: “We’re going to end early because

we’re out of legislation.” No, no. Let’s just cut one of the three weeks

left, the one in the middle. We’ll arbitrarily get rid of that so that

our tainted incoming Premier can have a five-day celebration for his

coronation after the tainted leadership race, a leadership race that….

The incoming Premier was frustrated that there was even an opponent in

it because he wanted to get on with work, and now we’ve removed a third

of the debate time for Bill 36.

Deputy Speaker: If I might draw the member back to the bill. We’re on Bill 36.

Thank you. Member.

P. Milobar: A third of the debate time for Bill 36 has just been removed

today. A third of the debate time for an Indigenous child welfare bill

has been removed unilaterally. That’s the level of transparency that

health professionals can expect out of this government, moving forward,

as Bill 36 gets enacted, apparently.

[2:20 p.m.]

It’s shocking. It’s shocking that the 26 different colleges can

expect a government that will just do as they please and that college

board shall be happy with it. It’s shocking that they will not be given

the courtesy of a proper understanding of every clause in this bill with

the proper and investigative rigour that it’s supposed to have when

legislation comes forward.

I remember when we wound up debating two forestry bills at the

same time in two different rooms in this building, fundamentally

changing forestry in our prov­ince. I thought that was the height

of arrogance out of this government. But apparently, Bill 36 takes it to

a whole new level.

It’s absolutely shameful — the complete arrogance, the disdain

being shown by this government to the health professionals — that they

would remove a third of the remaining debate time from the legislative

calendar mid-session, right when we’re getting ready to put a critical

eye on a piece of legislation as important as this.

At a time when we have crumbling health care in our province, at a

time when we’re struggling to recruit people to our province not just

from the rest of Canada but from the rest of the world, a bill like this

could go a long way to helping those recruitment efforts. It could also

do the exact opposite, and it could drive people away from British

Columbia. That’s why Bill 36 deserves to have the proper scrutiny and

not have a third of the debate time ripped away by an arrogant and

out-of-touch incoming Premier simply so he can have a vanity party for

four extra days before he gets sworn in.

When you look at all the clauses, the 645 clauses in this bill,

and how they interconnect and how they are meant to modernize and update

how colleges operate, it gets very complex very quickly. It is not a

bill that you can simply spend an hour or two on at committee stage and

say good enough. Nurses, doctors, all the other health professionals in

this bill deserve the respect of this chamber to fully investigate Bill

36 and how it will impact their livelihoods, their working conditions,

their licensing regimes, what control over their own professional

standards they’ll have or won’t have.

They didn’t deserve the slap in the face by the incoming Premier

of a removal of a third of the time left to try to actually get those

answers for them. These are a group of people that we’ve relied on

through the pandemic, through the opioid crisis, through every type of

health emergency you can imagine either on a personal level or on a

community level — fires, floods, you name it. They deserve

better.

This is a group of people who, by their very nature, dig into the

topic and subject matter and investigate. I would be shocked if they

don’t actually have a ton of questions they would like to see asked — if

not word for word, at least where their headspace is at. They are

science-based, fact-based, data-driven people, because if you’re not

wired that way, good luck trying to get through your medical training.

They’re naturally inclined to fully investigate things and want things

well explained and want to understand what end points are going to be,

the cause and effect of things. That’s how they’re wired.

[2:25 p.m.]

The incoming Premier doesn’t seem to care. Remove one-third of the

debate time left — full stop — because there’s apparently a need to have

an extra four days of celebrations before an actual swearing in. It

would almost be more understandable if the swearing in was happening on

a Monday, and they cancelled the rest of the week. It still wouldn’t

make it right, but it would be understandable.

Instead of debating Bill 36 on that week, the incoming Premier, I

guess, wants to have a party on Monday, a party on Tuesday, a party on

Wednesday, a party on Thursday. He can go and do that. We can stay in

this chamber and do the work. We just need the Health Minister. Frankly,

I could care less if the rest of the government caucus is even here. We

could stay here and properly debate, properly investigate Bill 36. I’ll

guarantee my colleague from Prince George–Valemount, our Health critic,

would love to be here working on behalf of the public, working on behalf

of the health professionals that are going to be greatly impacted by

this bill.

If the health professionals are greatly impacted by Bill 36, that

means every British Columbian — especially that million that don’t have

a family doctor right now — is going to be impacted by this bill. The

people that don’t have access to a walk-in clinic are going to be

impacted by this bill. The people who, the radiologists are warning us,

are going to have a tsunami of stage 4 cancer because of delays for

diagnostic tests, are going to be greatly impacted by this

bill.

I get that the Premier-designate doesn’t want to be in this

building for that four days. I don’t understand why everyone else had to

be told to stay home too. What the heck are the taxpayers of this

province paying everyone in this building to do? They’re not paying us

to take an extra four days off when you have critical legislation like

Bill 36 or Indigenous child welfare protection bills on the docket to

discuss. But that’s the priority of this government, of this incoming

Premier — zero accountability to make sure that the colleges impacted by

this bill, in Bill 36, actually know what is going on.

Let’s not forget that there’s a whole whack of other business we

could be tackling as well as Bill 36. We could deal with the private

member’s bill about pay raises for MLAs being suspended for a year. Not

a great shock that the government doesn’t want to talk about that, I

guess.

Deputy Speaker: If I might, member….

P. Milobar: There’s all sorts of business, Mr. Speaker.

Deputy Speaker: We speak about the bill in front of us as opposed to other bills

at this time.

P. Milobar: Yes. Thank you. I’m simply trying to draw a parallel that Bill 36

is critically important to the province. We’ve heard that from speaker

after speaker after speaker. In fact, we’ve heard that from government

speakers, the few of them that did actually speak to this, and I agree

with them.

Part of our legislative process, the scrutiny piece that’s so

important…. We call this second reading bill debate, but I think it’s

safe to say that this is second reading bill speeches. There is no

typical back-and-forth debate, like one would expect when you hear the

word debate. The real meat of Bill 36, the real work that the public

needs to see happen on Bill 36, is the next phase. It’s committee

stage.

Now, again, people at home are probably thinking: “Well then why

did we put up so many speakers? Why didn’t we just jump into committee

stage?” Well, because you have to have a little bit of faith and trust

in a government when they bring forward their legislative

schedule.

[2:30 p.m.]

When the Government House Leader tells us and tells the media and

tells the public that there are 17 to 20 pieces of legislation, and we

find ourselves with only two pieces of legislation left before today,

you start to get worried that they’re actually just doing what they can

to get out of here early. Frankly, we had to put up a bunch of speakers

to Bill 36 because the government didn’t have any legislation for us to

work on up until just recently, shameful when you consider how long

they’ve had to get the bills ready.

As we’re in mid Bill 36 debate, the other shoe finally dropped.

The government finally acknowledged what we had suspected was going to

happen for a little while here. They’re just going to remove debate

hours. “Nothing to see here, folks. Don’t worry about it.” We’ll go from

12 debate days down to eight days worth of debate to try to actually dig

into a 645 clause bill on health professions.

I don’t know how many days that’s going to leave us to dig into

bills like the one for Indigenous child welfare protection. We’ll get to

the Indigenous child protection bill in future days.

It’s shameful how little time we’ll actually have on behalf of

nurses and doctors and all those in health care that are protected by

their colleges, operate under their colleges. Their practices are guided

by the colleges. It’s a complete disservice to all those women and men

that work, to all their patients, to the million British Columbians that

don’t have a family doctor that were hoping that maybe this bill would

provide some insight on how we would get foreign-trained doctors into

the system quicker.

Instead of that, our incoming Premier would rather talk about what

type of curtains he’s going to have or which type of pastries and tea he

might share with the Lieutenant-Governor. Again, if that’s what the

Premier wants to spend his time talking about, that’s fine. This House

can still operate. This House could still be sitting with the Health

Minister talking about Bill 36 in that week. We could dive into those

645 clauses and not have to rush past big sections of them.

I know this might come as a shock to some on the government side,

but there have been many bills that have come forward that have had

flaws in them. Some are minor amendments. Some have been major

amendments that have been caught by the opposition over the years, and

the bills had to be adjusted.

With a bill this size, it would not shock anyone if there were a

few of those such errors, honest mistakes, honest errors, especially in

a day of cut and paste and drag. An older version of a clause gets left

in the final edit instead of the updated one. As we’re questioning, it

becomes apparent that an honest mistake has been made. It gets corrected

then. It doesn’t get corrected after the fact.

We’re not going to have the benefit of that time on Bill 36. As

much as we say there are eight days of debate left now instead of 12,

the reality is…. That eighth day is the day, after lunch, that the

Lieutenant-Governor comes and gives royal assent to the rest of the

bills. That’s a partial day, at best. That’s a couple of hours, if we’re

lucky. So it’s really seven days left. It was 11 until one o’clock

today, when it magically became seven.

It’s shameful that the government caucus seems to be more

celebratory of the fact that they got an extra four days off…

[2:35 p.m.]

Deputy Speaker: If I might bring the member back to the bill.

P. Milobar: …than worrying that we lost four extra days on Bill 36. Those four

extra days, those four days of legislative calendar time for Bill 36,

which the taxpayers are paying us all for, which this cabinet gave

themselves a retroactive pay raise to do the work of the public for, not

to have tea and pastries with the incoming Premier for an extra four

days.

The taxpayers are paying us to debate Bill 36, to dig into the

questions on Bill 36 on several key areas. It’s a complete redesign of

the Health Professions Act. It has been worked on for a couple of years

now, multiparty work. That gets blown away, and its debate time shrunk,

for an incoming Premier’s vanity project. The last vanity project, the

museum, didn’t go over so well either. We’ll see how well the extra days

for celebration go over with the public, when we could be discussing

this bill.

I know the Health Minister is a very hard working minister. That

is of no dispute. I’m willing to bet, in his heart of hearts, if he had

a choice of standing in this House and answering meaningful questions

for an extra four days from our Health critic on a piece of legislation

that he and his staff and others in this chamber have worked on for

years, to make sure that the professionals impacted by this have a full

understanding of it…. I’m pretty confident, in his heart of hearts, the

Health Minister would rather have that happen than stand around making

small talk, with tea and pastries, with the incoming Premier for four

days.

That’s not going to happen. It’s shameful. It shows what happens

when a government loses touch so badly with the public, the public where

20 percent of them don’t have a family doctor, the public where a great

many are going to wind up with stage 4 cancer because of a lack of

diagnostic services.

Interjection.

Deputy Speaker: Members. Members, please, if you need to have…. Whatever you’re

doing, please take it outside. We have a member who has the floor. Thank

you.

P. Milobar: Well, I would say, based on the laughing and the entertainment the

government members are having right now…. That says all we need to know

about the drive and the work ethic by the vast majority of their caucus,

as it comes to Bill 36 and the seriousness that this actually

represents.

There’s a complaint process that’s revised in this. How will that

all work?

Yes, we’ll have time to ask a couple of questions. We’re not going

to have time to fully dive into it. I guess the one saving grace is,

again, that the Health Minister is not known to be wanting to take

forever to wait to turn around. There are some ministers where you’re

lucky if you get in four questions an hour. At least we’ve got that

going for us. It’s still not good enough, though.

As I say, I’ll guarantee…. Well, I can’t guarantee. I’m not going

to presume what the Health Minister truly thinks. Based on his track

record, it would shock me that he would not rather spend more time on

this bill answering questions, educating the public and educating the

health professionals on how Bill 36 is going to impact their daily lives

and whether or not it will truly help what ails our health care

system.

Our health care system isn’t heading towards a crisis. It’s not

starting to crumble. Our health care system has crumbled. Our health

care system is in a full-blown crisis. Our health care system has a

shortage of doctors, of nurses, of every other health professional

that’s covered by this act. This act, implemented properly, could very

easily help us attract those very same professionals to our

province.

[2:40 p.m.]

If those

interpretations of the various clauses are just left up

for each individual reader to guess what the government was thinking and

their intention when they drafted it, that’s not a good thing. You want

them to be able to go into Hansard . You want them to be able to

view the video or read or listen to the exchange back and forth between

the minister and our side of what those clauses actually mean, what

their intention is, how they are seen to be rolled out, how things like

discipline or appeals will be handled, whether or not people’s names

will be made public after misconduct has happened and proven or

not.

All of those things are important to get a good understanding of.

All of those things are touched on in Bill 36. All of those things are

in those 645 clauses, and all of those things just had over a third of

their debate time ripped away by the incoming Premier for absolutely no

logical reason.

As we get into committee stage on Bill 36 — I’m assuming it will

be next week — it will be important to dig in to how Bill 36 overlaps

with UNDRIP. UNDRIP, I will remind this House, took over a week’s worth

of debate — that bill. So I’m still trying to understand how a bill that

complex, overlayed with this bill…. It’s going to take a lot of

time.

And it’s important to understand how it overlaps. It’s important

for First Nations Health Authority and people within the First Nations

health provision side of the equation get a good understanding of how

this bill will impact them and the provision of health care for them and

their members — how it will help, how it will change cultural practices

within certain professions.

Those are all valid, important questions we need to get on the

record and dive into. A lot of them won’t just be solved with one quick

answer. They’ll require multiple ones. But the incoming Premier has

removed a third of the debate time. It’s unfortunate that we will not be

able to dive into this bill properly.

I thank you for the time on Bill 36.

T. Stone: I am pleased to take my place in this second reading debate on

Bill 36, the Health Professions and Occupations Act. I want to first

start off by acknowledging the contributions to this debate that have

been made by many members of this House, certainly on the opposition

side. Save the Leader of the Opposition and the Assistant Deputy

Speaker, once I’m finished, every member of the official opposition will

have weighed in on this piece of legislation.

We’ve done that because we recognized, as a caucus and, I think,

as individual MLAs, the significance from a policy shift that Bill 36,

the Health Professions and Occupations Act actually

represents.

[2:45 p.m.]

I want to, however, in following my good friend and colleague from

Kamloops–North Thompson — who just completed his remarks, eloquent as

always — build on, I think, an important theme that he went to great

length to articulate and put on the record. That is that Bill 36 is one

of a number of pieces of legislation that are on the order paper that

the government, as is the government’s prerogative, has brought forward

as a piece of the government’s legislative agenda and, obviously, their

policy priorities.

Government has introduced this Bill 36 and these other pieces of

legislation that, in several cases, have not even gone to second reading

yet and, in many cases, haven’t gone into committee stage yet. And there

are supposed to be three weeks left in this legislative session after

today.

Next week, the week of October 31, we’re here for four days. We

then go back to our constituencies for four days, during the Remembrance

Day period — very important to do that. Then we were to be back here for

two weeks, taking us from the 14th of November to the 24th of November.

So eight session days after the Remembrance Day break and four session

days next week — that’s a total of 12 days beyond today in this

session.

That was the time that was mapped out by government. That’s the

time that’s mapped out in the parliamentary calendar. That’s,

presumably, the time with which the government made the decision to

bring forth the bills that are in front of us, including this Bill 36,

the Health Professions and Occupations Act.

You can imagine our surprise and our shock to learn today, at one

o’clock, that it is the government’s intention to shut this place down

for an extra week in the middle of November, leaving eight days for

debate on all of the legislation that’s still in front of this House,

not the 12 days that are provided for in the parliamentary

calendar.

Bill 36 is not your typical piece of legislation, most notably

because…. Well, there are two things, but most notably, it’s a bill that

contains 645 sections. This is a huge piece of legislation that has very

significant implications. It represents a very dramatic shift in the

regulatory environment — within which a range of different colleges,

whether it be the Doctors of B.C. or dentists or occupational

therapists, respiratory therapists, opticians and optometrists; on and

on the list goes — and how these different bodies are to be regulated,

moving forward.

The bill provides a roadmap of change that I think, from a

principles perspective, is pretty sound, in that at the heart of these

changes, as I understand them, the overriding value — that is, the

desired outcome of these changes — is to improve patient safety — to

ensure that the British Columbian who needs eye care or who needs to go

and spend some time with a respiratory therapist or their doctor or

their dentist…. That British Columbian can better rest assured, with

this new regulatory environment that’s being proposed in Bill 36, that

patient safety and their well-being, their best interests are at the

centre of what these changes are all about.

So 645 sections. This is the largest piece of legislation that

I’ve dealt with in my near-ten years in this place, but it’s also one of

the most complicated. I should note that this body of work, which

represents a complete redesign of the Health Professions Act, is

preceded by recommendations that were made in August of 2020 by the

Steering Committee on Modernization of Health Professional Regulation,

as well as a 2018 report by Harry Cayton that considered changes to the

health regulations act.

[2:50 p.m.]

It was all of that heavy lifting that was done by, frankly,

representatives of each of the different parties in this place. I take

my hat off to the Minister of Health, to the Leader of the Third Party

and, very notably as well, my colleague the member for Kelowna–Lake

Country, who, on behalf of the official opposition, participated in a

very lengthy but thoughtful and respectful process.

Not just talking amongst the three of them, but really approached

it from a place of collaboration and reaching out to all of the

different health professions, reaching out to all of the related

stakeholders, engaging with British Columbians, taking all of that

feedback and incorporating it into a set of draft recommendations, which

then were tested again and again with the professions and with

stakeholders and with British Columbians and were refined into another

set of recommendations, and eventually made their way into this Bill 36,

the Health Professions and Occupations Act.

It’s a bill that introduces two distinctions, health professions

and health occupations, as provided for in clause 6. As I said, it’s a

large bill. It’s an ambitious bill. It’s a bill that provides for a

completely modernized approach to how these professions will be

regulated, with patient safety at the heart of doing that. It’s a piece

of legislation that represents a significant departure from the status

quo.

Just because I stand here and I applaud the efforts that went into

arriving at this place with this massive 645

section bill, that must not

be confused with any suggestion — or any assumption, is probably the

better word — that this bill is necessarily a done deal. It’s not a done

deal until we come into this place and we actually debate it, like we’re

doing here. It’s not a done deal until we go through a very rigorous

scrutiny in committee stage,

section by section, 645

sections.

In the opposition, our very able Health critic, the former Leader

of the Opposition; the member for Kelowna–Lake Country; and a number of

other members of our caucus…. I know I speak for our Green colleagues as

well. There is a high degree of intentionality here to do good by

British Columbians with this piece of legislation. We do that in the

opposition by asking the right questions, by asking tough questions, by

seeking clarification, by understanding the intent behind specific

sections. The devil’s always in the details. We do that by ensuring that

the government’s stated objectives actually are matched from an

implementation perspective by how the piece of legislation is actually

drafted.

I think my good friend from Kamloops–North Thomp­son, who

spoke before me here, made the point — and it’s a very valid one — that

in that moment of scrutiny in committee stage, we have often identified

issues with how a

section is drafted and what the unintended

consequences might be if it’s not fixed. And it has been the case where

government has accepted, frankly, amendments on the floor from the

opposition. Sometimes the government, because the opposition highlights

a deficiency in a piece of legislation, which may or may not be the case

with this Bill 36….

[2:55 p.m.]

In past experience, occasionally, we’ll identify something as an

opposition and the government will take it upon themselves to actually

check the ego at the door and say: “You know what? You’re right about

that.” And the government will bring forward an amendment to their own

piece of legislation.

The whole process is intended to strengthen a bill, to make a bill

as good as it possibly can be before it actually becomes law. I mean,

that’s a pretty foundational obligation that I think we all have as

legislators in this place.

It is beyond frustrating to realize that with a bill that will be

heading into committee stage presumably at some point — I’m assuming

next week, but it could be in the final week of the legislative

calendar…. I’m sure that the Health Minister is just champing at the bit

to get on with it in

section by section.

You can imagine how frustrating I think British Columbians will

feel when they realize that with such a significant piece of legislation

as Bill 36 — the Health Professions and Occupations Act — significant

not just in in size, significant in implication and impact, significant

in the change it represents…. And the incoming Premier has decided to,

essentially with the stroke of a pen, just cancel four days of session

that we’re supposed to have between now and the end of November — four

entire days.

We were supposed to be sitting for another 12 days after today. At

one o’clock today, we find out that because the incoming Premier is to

be sworn in on Friday, November 18, and that there needs to be a

swearing-in ceremony at Government House, an extra week of not being

here is required. It’s absolutely absurd.

It’s 645 sections, Bill 36.

Part 1 is all the

interpretations and

guiding principles. Some very significant changes provided for there

around sexual misconduct and sexual abuse and discrimination,

applications if reference to health profession corporations. On and on

it goes. There are 15 sections of this bill provided for in

part 1.

Part

2, designation and the model of regulation. All kinds of sections there

that take you up to

section 35 inclusive. Those two parts are going to

require significant time and scrutiny in this place.

Part 3 deals with the practice of designated health professions.

The authority to practise, making licence or permit applications,

licences generally, health profession corporation permits. Division 5 is

“Duties of licensees.” “Duties to report licensees,” “Prohibition

against adverse actions,” “Quality assurance programs,” “Discipline for

administrative matters.” I’m now up to

section 106. Division 10,

“Discipline of health professions corporation.” Division 11 is

“Complaints and initiating investigations.”

I mean, all of this is going to require time to ask the right

questions. Time to clarify intent. How about division 12,

“Investigations of fitness and misconduct”? That sounds pretty important

to me. “Capacity evaluations” in division 13. “Summary action or

disposition during investigation” — that’s division 14. That’s about ten

sections of the bill. “Citations for discipline hearings.” “Discipline

hearings” is a big chunk of this bill, rightfully so — protection of

persons in vulnerable circumstances, considerations for protection

orders.

These are the different

section headings, which denote the

significance of the content. Division 17, “Orders after discipline

hearings.” That takes us to the end of

part 3. We’re up to

section 197

at this point.

[3:00 p.m.]

But no, it’s more important to take an extra week not being here,

to take four days out of the legislative calendar so that the incoming

Premier can be sworn in on November 18, over two weeks from

now.

[J. Tegart in the chair.]

What makes this truly offensive is that the outgoing Premier has

tendered his resignation as Premier of British Columbia. He’s tendered

it. He went and saw the Lieutenant-Governor yesterday. His resignation

takes effect upon the new Premier-designate being sworn in as Premier.

The Premier-designate sets the

schedule for that. The Premier-designate

could have been sworn in yesterday. That’s often how it

happens.

One Premier drives up and goes in and says, “Thank you for the

opportunity to serve as the President of the Executive Council; I tender

my resignation,” gets back in the car and drives away as a private

citizen. The next Premier drives up, and the Lieutenant-Governor asks

him or her to form a government. We saw the charade of the

Premier-designate going up to Government House to have the

Lieutenant-Governor ask him to form a government and presumably have

some pastries and some tea or whatever.

This is a 645-page bill. We have Bill 38, the Indigenous

Self-Government in Child and Family Services Amendment Act, which

actually transfers responsibility to First Nations for Indigenous child

services, part of the commitments made through the reconciliation

process driven by DRIPA. A bunch of other bills. But we’re going to cut

four days out of the legislative calendar because the Premier-designate

wants to make this big huge show of this transfer of power instead of

just strapping in and doing his job.

He should be sitting here in his seat. He should be here on

Monday, as the Premier of British Columbia, answering the tough

questions. He’s been in government for 5½ years. Why is a delay to

November 18 for a swearing-in required at all?

We have a health care system collapsing all around us. We have

crime completely out of control when it comes to random assaults. We

have very important legislation like Bill 36, the Health Professions and

Occupations Act, in front of us, 645 sections. We have the Indigenous

Self-Government in Child and Family Services Amendment Act. We’ve got a

passenger transportation amendment act. We’ve got energy statutes

amendments. We’ve got the Income Tax Amendment Act.

We’ve got all this legislation in front of us, including Bill 36,

and the incoming Premier of British Columbia is choosing to delay being

sworn in by over two weeks and to yank four days out of the legislative

calendar. It’s absolutely absurd.

This is also against the backdrop of a government that hasn’t

joined with the opposition to forgo pay increases for the forthcoming

year. Could see increases of 7 percent to 10 percent, each of us as

MLAs, if the government doesn’t do the right thing there.

Secondly, this is a government that gave themselves retroactive

pay increases for cabinet, like 10,000 bucks a person. “But we’re going

to work less,” is really the message that they’re sending. “We’re going

to take four days out of the calendar.”

The ability of the opposition to do its job as effectively as it

possibly can on behalf of British Columbians, especially on a huge and

complicated piece of legislation like the bill in front of us today,

Bill 36, depends first and foremost on our ability as an opposition to

have the time in this place to actually ask the tough questions. Now, we

know that that’s not necessarily the default of this government. In the

last session, they brought down the guillotine and time allocation on a

critical piece of forestry legislation.

[3:05 p.m.]

The Minister of Health is smiling. He knows what…. I can tell

through your eyes, to the minister. I can tell by your eyes. Now you’re

definitely smiling. It’s not funny.

Interjection.

T. Stone: It doesn’t matter if you have smiley eyes. You’re

smiling.

The fact of the matter is we need time. I know that the Minister

of Health wants to get into it with us. On this bill, I fully expect,

when I say, “get into it with us,” that he wants to get into a

thoughtful discussion and debate about the contents of this legislation,

which… As the sponsor of the bill, I’m certain that the Minister of

Health is proud of this piece of legislation. I know that the Leader of

the Third Party is proud of this legislation. I know that the member for

Kelowna–Lake Country, who collaborated closely with the minister, is

proud of this legislation.

It doesn’t mean that you just come in here, and what are we going

to do? We’re going to go: “Oh yeah. Well, we’ve only got half an hour

left in the day, so we’re going to go with sections 17 to 151. All in

favour?” If only it was that easy. That’s not the way this place

works.

It’s not too late for the government to change its course on this.

It’s not too late for the incoming Premier to recognize that it doesn’t

need a two- to three-week buildup. I mean, the fix was in. He’s the

leader of the so-called race. He’s the Premier-designate. He’s met with

the Lieutenant-Governor. She’s asked him to form a government. She’s had

tea with him. He’s been in transition discussions for weeks. The current

Premier has actually tendered his resignation, effective upon the new

Premier being sworn in.

There is absolutely no reason that passes the smell test with the

public that the new Premier shouldn’t be in this chamber on Monday

morning in his seat, answering the tough questions in question period

and being accountable for his record, talking about his vision for the

future, his 100 days of action, and allowing for the space in the

schedule to actually go through this piece of legislation with the

scrutiny that it requires.

Part 4 of this bill deals with the authority to practice, duties

of regulated health service providers, complaints and investigations. If

the minister thinks that we’re just going to skim over these things or

that that would be our ideal intent…. I know he doesn’t think that, but

if anyone were to think that, they don’t have much of a clue as to the

significance of this legislation in sections like that — the decision

after investigation. Disclosure of information — that’s pretty

important. That’s division 2 of Bill 36.

The Health Professions Review Board is actually brand-new, pretty

darn important. We’re going to have a few questions about that. The way

it’s structured is new. We’re going to have questions about that. All of

the regulators in

part 8. There’s a whole bunch of stuff there,

literally dozens and dozens of sections of this bill. I won’t go through

all 645 sections, which I’m sure the minister will be happy to hear. I’m

running out of time, as well, which I know he’s happy about.

This bill does change things dramatically in terms of how these

colleges, these professions, are regulated. The appointment process is a

significant departure. What’s provided for in this bill — significant

departure from what the status quo is. I’m not saying it’s wrong. I’m

saying that it maybe isn’t the right place to be, but it’s a significant

departure. It requires scrutiny. It requires us to ask those questions,

and we certainly will.

[3:10 p.m.]

There is, for the first time ever, the separation, this

con­cept of two distinctions — right? — between health professions

and health occupations. That’s significant.

There are a bunch of new provisions in this bill that deal with

credentialing. We hear it from members on all sides of the House, the

frustration that we often hear back in our constituencies. I’ll give you

an example, from a doctor’s perspective in primary care. We all know the

shortage of doctors we have — one in five.

Well, one of the barriers is a more seamless and expedited process

of recognizing credentials of doctors, family physicians that are

trained outside of British Columbia. Maybe they’re trained somewhere

else in Canada. Maybe they’re trained internationally

somewhere.

I had a constituent who called me one day and said: “It’s too late

for you to do anything about this, but I just thought you should know

that my son, who was born and raised in the village of Chase….” And

Chase has a population of 2,500. He wanted to follow in his father’s

footsteps and become a family doctor. Chase, like many communities

around the province, is underserved when it comes to family doctors.

Well, good news — a local kid, local boy, a local young man wants to

become a doctor.

He’s top of his class, but we all know how competitive and

difficult it is to get into the University of British Columbia — so few

seats, so many that are trying to get in. He couldn’t get in, but he did

get accepted to go to university in Dublin, Ireland, an internationally

recognized and acclaimed place, a university that trains a lot of

doctors. So he goes there, and he goes through the training, and he

becomes a doctor.

Double benefit — he meets an amazing young woman, an Irish woman,

who is also in the same program as him. She becomes a doctor at the same

time. She decides she wants to move with him. They get married. They go

back to Chase. Chase is going to get two doctors. They want to live in a

small town.

Could they get the credentials dealt with in a timely fashion?

Could they get a residency in British Columbia? No. And where are they

practising today? They are both practising in Florida. I mean, what a

shame.

That whole credentialing process…. I’m not saying there’s a silver

bullet in here, but it certainly contemplates making some improvements

around that. It needs the discussion and the debate, the

time.

The incoming Premier should just dispense with this notion of

ripping four days out of the legislative calendar. He should get sworn

in today or tomorrow, show up on Monday to do his job.

With that, I will take my spot.

Deputy Speaker: Seeing no further speakers, does the minister wish to close

debate?

Hon. A. Dix: Thank you very much, hon. Speaker. I want to start by expressing

my appreciation to all the members who took

part in this debate on what

is, indeed, an important piece of legislation.

I want to talk about a few of the themes. There was a wide range

of themes discussed, and some of them even related to the legislation.

That’s a good thing. I wanted to talk and respond to some of those

questions.

I want to express my appreciation to the opposition Health critic,

the member for Prince George–Valemount; and the Green Party Health

critic, also the Green Party Leader, the member for Cowichan

Valley.

The excellent speeches done, in particular, by my colleague from

Kelowna–Lake Country, who took people, I think, through the process, in

detail, of how we arrived at the conclusions and the directions that

were provided by this legislation, by other members of the House, who

talked about health care in their communities and its significance, by

the member for Richmond-Queensborough who gave a very thoughtful

presentation on the value of the legislation, and all the members who

took

part in the debate.

It is, indeed, important legislation and, in the context, I think

unusual legislation in the way in which it was developed.

[3:15 p.m.]

I would say the genesis for part of that legislation came, indeed,

even prior to my becoming Minister of Health in the sense that a process

was developed by nursing professionals to merge the four nursing

colleges into one, to recognize that people who work together in health

care teams and who have the same profession broadly have common

interests and can become a better regulatory organization — provide

better service to the public, better response by patients — by coming

together. One of the first pieces of legislation that I introduced in

this Legislature was legislation that merged those four nursing

professional colleges together.

Subsequent to that, we had concerns that were related to the

College of Dental Surgeons. We asked internationally recognized expert

Harry Cayton and, indeed, our team in the Ministry of Health that deals

with the regulation of health care professionals and with the public

that addresses those issues…. We had Mr. Cayton do a report both on the

College of Dental Surgeons, all of whose recommendations were accepted

and implemented, but also do a broader look at the manner in which we

regulate health professions in B.C.

That manner and that act hadn’t been changed in 30 years and is

hugely dependent on regulation — in fact, much more, proportionately,

than this piece of legislation. I’ll come back to that theme because

it’s one of the themes that was put forward by the

opposition.

So we decided and developed, as members will know — members

referred to this in the debate — a steering committee that involved

members of all sides of the House — the member for Kelowna–Lake Country

and the member from Cowichan. I think anyone who witnessed that,

including in the public service, as we worked together on the

legislation, know they contributed enormously to the result we

have.

It’s unusual. It’s a process that I give them a lot of credit for,

because it’s a process of people coming together and saying we were

going to work together in a way that hadn’t really happened in that way

before. There had been, of course, work done across the floor at various

points. There was the Select Standing Committee on Aquaculture in about

2005, 2006, that was chaired by the opposition and that was set up by

the government. There had been other processes. There’s currently a

legislative standing committee process around recommendations. But those

processes tend to result in reports and then action, presumably, but not

in legislation.

We developed this process together, and I think that it’s a real

credit to them. You can see from the speeches of both the member from

Cowichan and the member for Kelowna–Lake Country how thoughtfully they

contri­buted to that.

The goal of the exercise is to say that, indeed, in the 30 years

since the Health Professions Act was in place, there had been

significant changes in the way professions practise. Indeed, there had

been some significant differences in health professions. There were many

health professions that had not been regulated up to that point which

were now regulated. There was also a certain inequality in that, such

that some of the professions that had the least risk to the public had

the highest fees, for example, and had to set the highest

processes.

We have the College of Physicians and Surgeons that dates from the

19th century in B.C., and then we have others that are more recent. We

had one college that had 87 members. They had to tax their members to

set up a regulatory college to function — not the best approach. And we

had a process that was opaque to the public, to the very people who

might make a complaint about a health profession.

Another thing that the Cayton report shows…. The member for

Columbia River–Revelstoke talked about silos and being concerned that

the legislation may create silos. The legislation knocks down silos. We

had four dental colleges that, according to the Cayton report, had never

met. They’re all working in the same area. They hadn’t met together for

years prior to the review conducted by Mr. Cayton. So you had dental

hygienists, dental surgeons, dental technicians and denturists who were

doing the same work in the same field and not connecting.

Now, in advance of the legislation being passed, they’ve come

together as one college. Encouraged by, perhaps, the direction of the

members from Cowichan and Kelowna–Lake Country and myself and our

intention to proceed, they’ve already proceeded. Equally, the College of

Midwives joined the nursing college, and that’s a positive thing. The

College of Podiatric Surgeons already joined the College of Physicians

and Surgeons. Because of this direction, they are preparing and

anticipating the introduction of this legislation. I think that’s a

positive thing.

[3:20 p.m.]

There were 22 colleges when I became Minister of Health. There are

now 15. That’s breaking down barriers and creating efficiencies and

also, I think, a better response from the public that requires its role

be heard as well.

We had the recommendations and then, obviously, people in the

public service — working, of course, with the health colleges. We had

more than 6,000 presentations to our steering committee from members of

the public. We gave direction as to the legislation, and you see the

result of that extraordinary work by the public service.

I think there’s lots of talk about the size of the bill.

Typically, bills in this House are smaller because the original act is

not being changed. In this case, the changes are significant enough that

we have a new act. So whole provisions of the current Health Professions

Act and the health professions regulations are now subsumed in this

legislation. Some of them, parts of this bill, have in fact been in

place for a long time and are a continuation of that act. We’re

replacing the act, so they have to be taken up again in this

legislation, which is an important thing.

What the bill does — I want to get to some of the comments and

concerns of members of the opposition — I would say, is that it deals,

as I’ve discussed, with efficiency. It deals with patient safety,

patient voice, patient choice and patient accountability in a health

care system that needs to respond to those things, that needs to have

people and, for individuals who interact with the system at some of the

most important moments in their lives, to have those things

recognized.

It needs to have transparency, fairness and complaint processes —

this improves that transparency, and it improves that complaint process

in ways consistent with the recommendations of the members of this

Legislature — and it has to deal with cultural safety.

A number of members suggested that — because all of this didn’t

solve all the problems in health care — this wasn’t the right time for

it. Well, it is exactly the right time for it. We just had a major

report, in addition to the work done by the steering committee, called

In Plain Sight . It was written by a distinguished scholar

in B.C., Mary Ellen Turpel-Lafond. That report talked about the urgent

issues in dealing with Indigenous, targeted and specific racism in

B.C.

This legislation, which governs 122,000 health professionals,

deals specifically with that. We probably should have dealt with that 30

years ago, when we dealt with the Health Professions Act, but we didn’t.

That’s not a criticism of people who have acted before. That’s just to

say it is urgent. Anyone who has read In Plain Sight

understands its urgency. It’s why incorporating those provisions

into the act is so important.

These are the changes: better for patients, better for health

professionals, a more efficient process — a more efficient process for

us to regulate new health professions, and a more efficient process for

people who want to have their credentials recognized. Those are

important issues, they’re taken up in this act, and they reflect years

of work that we’ve done in important ways.

Members of this Legislature of all parties, current health

colleges, health professions, members of the public and of course the

outstanding staff of the Ministry of Health and the outstanding staff of

the Ministry of Attorney General have worked on these provisions. Now

with this legislation, which has occupied the last several days of

debate in this Legislature, I have been honoured to be part of that in

my presentations at second reading.

I want to deal with a couple of the issues that were raised by

different members. Some of these, of course, we’ll deal with at

committee stage. The member for Kelowna–Lake Country asked about

clarity, about issues around health occupations and the duties of

directors in that regard.

Section 6 of the act outlines the differences

between occupation and professional. This is intended to be a

lighter-touch way of regulating health occupations that have not been

trained as professionals. The goal is to regulate, in this case,

proportionate to the risk.

The member for Vancouver-Langara spoke about issues around Bill 36

and how it deals with issues around UNDRIP and around cultural safety. I

would say that this act, this legislation, has some of the most

comprehensive changes, to date, in legislation for cultural

safety.

[3:25 p.m.]

It’s hard-wired into every aspect of the new HPOA, the new health

professions and occupations regulatory framework, through guiding

principles at

section 14; anti-discrimination measures at

section 15,

making it clear that discrimination is misconduct and actionable

conduct; and revamping the complaints process by enabling restorative

processes that could be influenced by Indigenous practice — that’s

sections 157 and 268; as well as enabling support workers and access to

counsellors for people that have experienced discrimination. This is

necessary. If people are saying, “why now?” they need to read In

Plain Sight .

Clear expectations for regulated health professionals for

providing services ethically, in compliance with anti-discrimination

standards, are set here in collaboration with one or more persons

nominated by an Indigenous governing body and our representative bodies.

Those are

section 70 and

section 384, requiring the superintendent to

collaborate with one or more persons previously nominated by Indigenous

governing bodies when conducting an oversight process that relates to

Indigenous matters.

In terms of some of the issues raised by the member for

Vancouver-Langara, these are redresses that I look forward to talking to

him about at committee stage. The member also asked how Bill 36 enhanced

collaboration with Indigenous people when they’re in health crises. It

requires consultation with Indigenous people whenever the changes being

proposed affect them. The member asked how Bill 36 grants access to the

right to traditional medicine. The investigation committee cannot

investigate a person solely for practicing Indigenous medicine in place

of mainstream health care, unless that service is intentionally

misleading or causing harm.

The member for Kelowna–Lake Country went through a great deal of

the consultation that has been put in place. Members asked about the

costs of amalgamation of health services. Well, we’ve already done a

significant number of those amalgamations. For example, the amalgamation

that has already taken place between the College of Physicians and

Surgeons and the College of Podiatric Surgeons cost about $130,000, all

in. Obviously, we’ve gone from two colleges to one. That has benefits

into the long term.

The integration, in 2020, of the College of Midwives cost, in

total, $1.3 million. The amalgamation of all the nursing colleges — and

this came from the nursing colleges — from four to one, which started

under the previous government, continued under this government and was

passed unanimously by all of us in this Legislature in a bill introduced

by myself, at that time, cost a total of $4.5 million. That question was

asked during the legislative debate.

I want to say, finally, that there were a lot of questions and

concern about the bill being enabling. It replaces the current bill.

Again, one of the reasons the legislation is big is that it replaces the

current bill, and the elements of that bill that are still active have

to be taken up, of course, in this bill. There were also 30 years of

regulations pursuant to the existing Health Professions Act. The

previous Health Professions Act had, generally, three types of

regulations. This was an issue that’s taken up. There’s always this

concern, and it’s a concern that I share.

One of the reasons why the bill is long is that we do less by

regulation. This was an issue raised by a number of members — including

the member for Peace River South, in his initial comments in this longer

phase of debate — pointing out this concern that all of us have: should

things be explicit in legislation, or should you create regulatory

power? One of the reasons the legislation is this long is because it’s

my general preference to do the former, but it makes the legislation

longer.

The one way to make the legislation shorter — and the member will

be familiar with that through legislation introduced by his government

and other governments — is to create regulation-making powers. That

shortens your legislation, to do that. We wanted as much as possible of

this legislation to be explicit, so that health professionals and the

public who see the act can see the provisions and see how they apply,

and not see that in regulation. That’s an important issue that was a

theme taken up by a number of members in second reading, and I wanted to

address that.

The Health Professions Act currently has three types of

regulations. There are profession-specific regulations, which outline a

professional scope of practice and the restricted activities they can

do; designation regulations, outlining which professions are regulated

and what criteria are needed to regulate them; and lastly, general

regulations, which speak to timelines and emergency provisions. The new

act will have similar regulations to this, maintaining those. We leave

these to regulations for an important purpose. They change often, and

they should.

[3:30 p.m.]

As a member of the official opposition has stated, many have

stated, the legislation doesn’t change often. It has been 30 years for

this act. It may well be that long before we do this kind of amendment

again to this act — of this magnitude — but you cannot simply create

scope of practice and restricted activities on a particular profession,

or who is considered a designated health profession, just in

legislation.

You would have no ability, without changing legislation, to change

scope of practice or to regulate a new profession, such as clinical

counsellors, which many members on both sides of the House expressed a

desire to do. If this were the case, LPNs would still have no restricted

activities, and the speech and hearing professions would not be

professions. That’s why we have a combination, especially at the end of

the bill, of regulations, but a bill that is overwhelmingly in the

legislation.

We have, in fact, moved — for thi