Today I introduced to the legislature Christine Sorensen, President of the BC Nurses’ Union, Roger MacQuarrie, Communications and Campaigns Officer with the BC Nurses’ Union and Bonnie Christie, a Registered Nurse. They were in the gallery during Question Period and Member Statements.

Prior to me asking the Minister of Labour when he will ensure that the presumptive clause for work-related mental health disorders will be applied to nursing, I read out Bonnie’s incredibly moving story of mental injury acquired as a Registered Nurse.

Below I reproduce the text and video of that the story. My exchange with the Minister is available elsewhere.

Video of Statement

Text of my Statement

A phone rang in the intensive care unit at the BC Children’s Hospital. The call was from a rural BC hospital and they needed to transfer an 8 year old boy to the Children’s ICU right away.

Bonnie Christie was a senior Registered Nurse in the ICU that evening. When the boy arrived she started removing his bandages and blood began flowing like a waterfall. He had been ripped apart at the legs in a car accident while he delivered newspapers to his neighbours. He died shortly afterwards as he bled to death in the ICU.

In 21 years of children’s ICU nursing Bonnie has seen a lot of death and injury.

Bonnie remembers when two young girls were brought to the children’s ICU covered in third-degree burns. The girl’s mother died in the fire as her estranged husband tried to burn down their house and kill the family.

Bonnie remembers another young girl with burns so severe that they had to transfer her to a specialty hospital in the US. The girl’s mother set had her on fire while she was doing drugs.

She also remembers a young boy who was admitted with head wounds. When she took off his bandages part of his brain fell on the floor. His father tried to kill him with an axe.

Bonnie remembers other children who were sick and injured. And she remembers some who died horrible deaths. She can’t even count the number of horrible things she saw as a children’s ICU nurse.

After 21 years of critical care nursing Bonnie started having nightmares. She dreamt of pools of blood and people hanging on chain link fences with hooks through their scalps. At first she thought she only needed to get away from critical care nursing so she transferred to less acute roles. But after several transfers she kept having panic attacks. And anxiety. And more nightmares.

“I love nursing, but I’m still burdened by the events I went through,” says Bonnie. “I can never work in health care again and I don’t want any of my colleagues to go through what I did with WorkSafe BC. What we do is too important and too stressful for us to be re-injured in the process of trying to get help for ourselves.”

That was Bonnie Christie’s story.

On Friday I had the distinct honour of addressing the Canadian Association of Physician Assistants at their 2018 CAPA Annual Conference held at the Victoria Conference Centre (October 18-21).

Physician assistants are highly skilled medical professionals that work as part of health care teams to offer primary care to patients. As noted by the Conference Board of Canada, physician assistants are “a largely untapped resource that can help governments continue to provide high levels of service while reducing overall system costs”. Unfortunately, in British Columbia physician assistants are not a regulated profession.

Doctors of BC (formerly known as the BC Medical Association) is the organization that represents British Columbia’s physicians. In 2013, they issued a policy statement supporting the “establishment and deployment of physician assistants (PAs) in British Columbia.”

In particular, their policy statement recommended:

• physician assistants be recognized by the provincial government as a regulated profession, with regulatory oversight by the College of Physicians and Surgeons of British Columbia.
• Accessible, affordable, and adequate liability coverage be made available to and required of all physician assistants.
• The provincial government explore stable funding options for physician assistants.

The BC Green Party is committed to working towards the development of a community- and team-based approach to health care delivery in British Columbia. Physician assistants have an important role to play and we look forward to working with them in the weeks, months and years ahead.

Below I reproduce the text of my speech.

Text of Speech

Thank you for providing me with the opportunity to speak at the 19th Annual CAPA Conference.

Conversations about our healthcare system are more important than they have ever been. Our healthcare system was designed over 50 years ago and since that time we have seen significant changes in the demographic makeup of our country.

Since 1966, when the federal government passed the Medical Care Act, we’ve seen our population swell by over 10 million people. Canadians are living longer, and there are more of us entering the second half of our lives.

I don’t want to understate the challenge that these demographic changes will present to our healthcare system – or how other challenges further complicate this, especially in BC.

Just a few weeks ago our country’s new Parliamentary Budget Officer Yves Giroux put a spotlight on the demographic and budgetary challenges facing our healthcare system.

Mr. Giroux raised concerns that across numerous provinces the rising health care costs associated with Canada’s swelling population of seniors was putting significant strain on debt levels in a number of provinces.

He cited the increase in the senior dependency ratio – the rate of individuals 65 years or older relative to the population between 15-64 years of age. Nationally we will see it go from 25.2% in 2017 to 45.6% in 2092.

During my first term in office, I wrote about the challenges with the Canada Health Transfer – noting that BC has a higher proportion of seniors than the rest of Canada. Because it is an age demographic that requires more health services, I suggested the funding we receive should reflect the actual cost of services delivered.

As you well know, the federal Canada Health Act sets the standards for all provinces and requires coverage for all necessary care provided in hospitals and by physicians. But health care is ultimately the responsibility of the province.

So far, British Columbia has done a good job of managing the increase in health care spending compared to most other provinces.

While BC will see among the highest population growth in the country, we are second only to Quebec in terms of sustainable fiscal policy. This is despite the fact that BC is a retirement destination for many Canadians. It is common practice for individuals who have lived and worked – and therefore paid taxes – elsewhere, to move to BC later in life.

While this is certainly the largest healthcare challenge facing the provincial government from a financial point of view, the number one challenge currently facing British Columbians is the lack of family doctors.

I started my work on this file a few years ago with a policy review of how Canada has maintained and manipulated its doctor supply.

While there are no doubt countless contributing factors that influence doctor shortages, a few major policy changes shifted our course towards one critically deficient in family physicians.

In 1961, the average medical ratio in BC was 758 patients for each doctor. Much like today, however, the rural-urban distribution of doctors was uneven. In rural areas the ratio was much higher, at 1,229 patients per doctor, and 73.6% of the province’s physicians were concentrated in Vancouver and Victoria.

Sensing problems ahead, the federal Royal Commission on Health Services (who outlined the foundation for Canada’s universal medicare system) analyzed the medical workforce statistics and predicted an overall shortage of doctors by the 1970’s. Along with increasing med-student intake at universities across the country, the report recommended the establishment of at least four additional medical schools to meet the needs of a growing population. Their shortage projections extended until 1991.

When 1991 arrived, however, the perceived supply of doctors did a rapid reversal. A report presented to the Federal/Provincial/Territorial Conference of Deputy Ministers of Health by Barer and Stoddart cautioned that we were, in fact, heading towards a doctor surplus. Public policy shifted accordingly and drastic changes were made to the way physicians were trained and licensed in Canada.

In BC, the government introduced a combination of incentives and penalties in the hopes of shifting more doctors away from city centers and into remote areas. By 1993, travel assistance, isolation allowance, and subsidized, salaried positions were offered to doctors willing to move to more rural locations. At the same time, the government tried to manage doctors as they prepared to enter or exit the workforce. Young doctors looking to set up practices in areas deemed “oversupplied” were met with a 50 per cent reduction in their fee-for-service rate. This penalty only lasted a few years though, as it was challenged by physicians and the Professional Association of Residents of British Columbia and in 1997 ruled unconstitutional by the BC Supreme Court. The Court deemed the fee penalty imposed on urban doctors as a violation of the Canadian Charter of Rights and Freedoms guaranteed mobility and equity clause, as well as a breach of Canada Health Act’s requirement for reasonable compensation for insured services. Mandatory retirement caps set at 75 year were removed as well, following a legal challenge by the Senior Physician Society of BC.

A few years later, however, opinions had shifted yet again and the public and policy makers were back to being worried about a serious national doctor shortage. Incredibly, within a span of a decade the believed supply of doctors had done another complete reversal.

Five years after the BC government was taken to court for reducing urban doctors billing rates they were back to offering generous financial incentives. At the start of 2016, we found ourselves once again repeating history offering doctors a patchwork of financial incentives in an attempt to meet the province’s growing medical needs.

During their term, the previous government repeatedly vowed to end the doctor shortage. In February of 2013 they put $132.4 million into their ‘A GP for Me’ program and said it would ensure everyone would have a family physician by 2015.

Since then, the proportion of British Columbians without access a regular doctor has increased from 26% of the population in 2013 to 30% in 2017.

Given this province’s complicated history with doctor shortages, what I found most concerning about Liberal’s promise was not that they failed – One only has to look back at the struggles Canada has had maintaining an appropriate number of GPs to know this was never something that could be fixed in two years.

What is most concerning is that we failed to learn from the past and didn’t work to put the province on a path to systematically addressing the crisis over time.

We all know it can be incredibly challenging to address the structural limitations in our healthcare system, and that band aid solutions are not going to get us anywhere.

Healthcare is around 40% of our provincial budget every year. Throwing a little bit more money at it won’t be the solution either.

What I like to think makes the BC Green Party unique is that we are not afraid of change, and that even in opposition we try to take the challenges we face as a province, and find solutions and opportunities for new ideas to take hold.

So the truth is, I relish the opportunity to be here to speak with you. I think we need to be having a lot more conversations about health care in our country – how its funded, how our citizens access it, and how it is delivered.

This is why the BC Greens have been taking a hard look at two linked policy changes that could strike at the root at both the problem of long term affordability and the challenge of finding a family doctor: creating a larger emphasis on prevention, and using community based health care teams to help deliver the services British Columbians count on.

In our 2017 election platform, we put forward the idea of establishing a Ministry that is responsible for health promotion and disease prevention. I believe this is one of the most critical things we can do to mitigate long term health care costs.

Similarly, the Confidence and Supply Agreement established as a joint principle between us and the government the expansion of team-based health care, including the services of a variety of healthcare professionals. Such an approach, if done thoughtfully, can help lessen the crunch to find a GP, and actually increase the services that British Columbians receive.

I think the Canadian Medical Association captured it well in their 2017 report on the federal/provincial/territorial health accord where they argued:

“Canadians deserve a health system that starts with the patient at the centre. Such a system provides quality services in a timely, safe, effective, evidence-informed way that respects individual choice and that is actively supported by all involved in the healthcare system. To improve the patient experience, systems of services must be integrated so that professionals providing health promotion and protection, disease prevention, assessment, diagnosis and treatment, palliation… work in concert across home, community and hospital settings.”

It is within this framework that physician assistants play a critical role. Last year’s report from the Conference Board of Canada stated, physician assistants are “a largely untapped resource that can help governments continue to provide high levels of service while reducing overall system costs”.

The BC Green Party is committed to working towards the development of a community- and team-based approach to health care delivery in British Columbia. Physician assistants have an important role to play and we look forward to working with you in the weeks, months and years ahead.

Over the last week, I have been following the news that Ontario has decided to cancel its basic income pilot, only one year into what was supposed to be a 3-year project.

I am saddened by the decision made by the government of Ontario, for a number of reasons.

I was, of course, looking forward to learning from Ontario’s pilot project, which would have provided a wealth of evidence about the effects of basic income. Ontario was leading the country in assessing the impacts of this policy, and their project was being watched around the world. They were tracking changes in employment, health, education, food security and housing, as well as community-level effects in Lindsay, with independent assessment by university researchers.

Before Ontario, the last pilot in Canada took place in Dauphin, Manitoba, over 40 years ago. This pilot illustrated some very promising results: in just 3 years, hospital visits were reduced by 8.5%.
Researchers attributed this marked decrease to lower levels of stress in low income families, which resulted in lower rates of alcohol and drug use, lower levels of domestic abuse, fewer car accidents, and lower levels of hospitalization for mental health issues.

In deciding to cancel the pilot, Ontario, and our whole country, has lost a significant opportunity to learn about the effects of basic income and to be on the leading edge of exploring this policy.

But what has struck me the most in the last week since the news of cancellation are the individual stories coming out of Ontario, from those enrolled in the pilot, whose lives are deeply affected by this decision.

So many stories have highlighted how people’s lives changed once they began receiving basic income. These stories have highlighted, too, the substantial human cost to cancelling this pilot part way through, when thousands of people had made plans and decisions on what they thought was stable ground.

Some participants in the pilot decided to attend college for the first time, or returned to school, to pick up the skills needed for meaningful employment or to start a new career. Others began living independently, or found secure accommodation for the first time. For some, it was the newfound ability to afford healthy food and other small things to improve the quality of their lives, and the lives of their children. Others used the income to pay down long-standing debts.

Many spoke about the reduced stress they felt, the ability to plan into the future instead of worrying only about the day-to-day, and a feeling of greater independence and dignity.

Many participants in the program were working, but still couldn’t afford the necessities of life and make ends meet.

One individual who was part of the pilot wrote to me highlighting the impact that basic income had on him and his family. Despite both working, he and his wife had amassed a significant amount of debt, which they struggled to pay off as they tried to provide for their children. The program, he said, was allowing them to pay down their debt and do more with their children. Most importantly, he said, he could finally see the light at the end of the tunnel to better days, for him and his children.

In his words, “this program … gave people that really needed hope a lot of hope for a brighter future.”

These individual stories speak to the promise I believe basic income holds – as a better way to support people as they navigate the economic challenges of the 21st century. Recent years have seen disproportionate increases in part-time and contract work. Wages have stagnated while the cost of living in our cities has spiralled out of control. Meanwhile, studies estimate that half of Canadian jobs could be impacted by automation in the next decade alone. We proposed exploring basic income in B.C. because we believe that government needs to have a plan for the changes on the horizon.

The experiences of people in Ontario has made me see even more strongly the need to do serious work exploring this policy. I have previously written a four part series (Part I, Part II, Part III, and Part IV) outlining why I think basic income is an idea that we need to explore in BC. Establishing a pilot project formed a key aspect of the Income Security component of our BC Green 2017 election platform.

We’re forging ahead in BC with our expert committee, an expert panel comprising three distinguished researcher that launched last month and is studying how basic income could work in BC. This committee is the first step towards fulfilling a government commitment under CASA to pilot basic income in BC.  I am hopeful that the committee’s work will provide the evidence that governments need to decide how to proceed – not only here in BC, but across Canada.

In this time of change, as we grapple with the challenges we face today and on the horizon, policymakers have a responsibility to plan for the future, and to make decisions that will give their citizens the best possible chance to pursue their dreams and to achieve success. In a country as wealthy and as compassionate as ours, that’s the goal our leaders should be working towards.

On January 29, 2017 I wrote to the Minister of Health urging him to make all British Columbians with Type 1 diabetes eligible for insulin pump coverage. A few years earlier, the BC government had already made an important decision to fund insulin pumps for British Columbians under the age of 25.

Such a new policy change would greatly increase the quality of treatment for thousands of people. Insulin pumps reduce the likelihood of serious medical complications which can include kidney failure, blindness and amputation. These complications are not only devastating to individuals and their families, they are also incredibly expensive for our health care system. Funding insulin pumps is a cost effective preventative policy that would increase accessibility of treatment and quality of life for thousands of British Columbians.

Today I am thrilled that the BC Government will extend coverage to all British Columbians effective July 3, 2018. Below I reproduce our press release in response to the government’s announcement.

Media Release

Andrew Weaver welcomes expansion of insulin pump coverage
For immediate release
June 12, 2018

VICTORIA, B.C. – “I welcome government’s announcement today to expand insulin pump coverage for all British Columbians requiring one to manage diabetes, eliminating age restrictions,” said Andrew Weaver, Leader of the B.C. Green Party.

“This technology can be life altering for those who deal with diabetes. I’ve heard stories from a number of constituents, all of whom outlined just how significantly their quality of life improved due to the technology.

“Insulin pumps are not only an effective tool for patients to manage a very dangerous disease, they’re also a preventative and cost effective measure for our healthcare. This is a forward thinking policy which will lead to better treatment of diabetes for many British Columbians.”

Andrew Weaver called on the previous government in 2017 to eliminate age restrictions and extend coverage for insulin pumps to all British Columbians with type 1 diabetes, not only those under age 25.

-30-

Media contact
Sarah Miller, Acting Press Secretary
+1 250-858-9891 | sarah.miller@leg.bc.ca

Today during question period I rose to as the Minister of Labour when he was going to deliver on his commitment to more broadly extend the presumptive clause for work-related mental health disorders to other workers.

This was the first question that the minister has been asked since he was sworn in so he had a fair amount of “pent up answer” waiting for a question.

Below I reproduce the video and text of the exchange.

Video of Exchange

Question

A. Weaver: Mental disorders incurred from job-related trauma are serious injuries that can be debilitating. This government recently introduced protections by adding a presumptive clause for this kind of workplace injury. Now certain first responders are supported for injuries that can arise from the important work that they do.

While I am pleased that B.C. is extending protection for some workers, I’m concerned that others who suffer mental disorders on the job are being left out. Particularly, I’m profoundly troubled that professions such as nursing, teaching and social work — professions that employ disproportionate numbers of women compared to men — are being left out.

When I raised this issue earlier this year, the minister stated that he shared my concern and was committed to every worker getting the help and safety protection they need. What has the minister done to deliver on this commitment?

Answer

Hon. H. Bains: On the last day of the session, the last one to get a question, and I just want to tell you how thrilled I am to get that question. I want to thank the member for asking this question and giving me the opportunity to talk about the health and safety of workers in this province.

I share your passion about health and safety of workers in this province, Member. That’s why my goal is to make workplaces in British Columbia the safest in the country. You do that by having a strong preventative and training program so that we prevent injuries from happening in the first place. Then those who are injured or sick at workplace — that we treat them with respect and dignity and give them care and support when they need it so that they are able to go back to their pre-injury work as soon as they can.

That’s why we brought in Bill 9: to give protections to those workers who are first on the scene at a very dangerous and challenging situation. The first responders have been asking for these changes for a long time, and their requests have been ignored time and again. Well, we’re going to change that. I am considering expanding presumption to other groups of people, and as a result, I have been meeting with those groups — like nurses, CUPE, the dispatchers who are represented by CUPE — and other workers and with the member that asked this question so that we can continue to work to enhance and provide better working conditions for the working people of this province.

I believe and I know that everyone in this House believes that every worker deserves to go home healthy and safe at the end of their shift or their work. Anything less is unacceptable, and I do

Supplementary Question

A. Weaver: I’m beginning to regret asking these questions these last few days. Yet more pent-up answer looking for a question to deliver to.

I do have a supplemental. The supplemental is this. The Canadian Institute for Public Safety Research and Treatment at University of Regina undertook research that found that the percentage of 911 operators and dispatchers who suffer from post-traumatic disorder as a result of their work is comparable to those for police officers. But in B.C., affected 911 operators and dispatchers continue to fight for treatment and compensation while struggling with work-related mental health disorders.

We now have the tools to ensure they get the coverage they need. To the Minister of Labour: briefly, what concrete steps has the minister taken to expand the support we now offer to other first responders? And what steps are those now being applied to 911 dispatchers and call receivers?

Answer

Hon. H. Bains: Mr. Speaker, you can never be brief when you’re talking about the health or safety of working people in this province. The member knows that I’ve been discussing with him and other members of this House and all those workers who need better protection when they go to work. And they need protection when they are injured or sick at workplaces.

First responders have been asking for these changes for a long time. In fact, my colleague, the member now of Social Development and Poverty Reduction has put a private member’s bill in this House asking for just those changes that was ignored by the previous government.

UBCM 2016 passed a similar resolution and was ignored by this government. It doesn’t surprise me, member, because, if you’ve watched you watch for the last 16 years, the only time the members of that government stood up in this House to talk about workers was when they were ripping up their collective agreements, when they were eliminating the injured workers’ benefits, or when they were cutting their health and safety protection.

We said that we will do things differently. Workers know now that they have a government that respects them, a government that values their work. You know, we have taken some steps, and more is coming, Member — and everyone here — and workers know that