Shortly after reading a Member Statement outlining Bonnie Christie’s story about the trauma she experienced as an ICU nurse at BC Children’s hospital, I rose during question period to ask the Minister of Labour when he will ensure that the presumptive clause for work-related mental health disorders will be applied to nursing.

Below I reproduce the video and text of our exchange.

Video of Exchange

Question

A. Weaver: Mental disorders incurred from job-related trauma are serious injuries that can be debilitating. Last spring this government 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 they do.

While I’m 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. In particular, I’m profoundly troubled that professions, such as nursing, teaching, social work, 911 responders, that employ disproportionate numbers of women when compared to men are being left out.

When I raised this issue this past spring, the minister stated that he shared my concern and was committed to every worker getting the help and safety they need. What has the minister done — to the Minister of Labour — to deliver on this commitment?

Answer

Hon. H. Bains: I want to thank the member for the question, and I really want to thank him for his passion about workers’ health and safety, because I do share that passion.

I must say that I’m proud to say in this House that as one of the first actions as a minister, I changed the WCB act to make it easier for the first responders to access benefits for those who are suffering from mental health injuries, because first responders have been asking for these changes for a long time.

They were ignored by the previous government. We couldn’t ask them to wait any longer.

Bill 9 also, as the member mentioned, enabled me to add other groups of workers and provide them with better protection. That’s why I am meeting with all those groups of people that the member had mentioned, including CUPE, the nurses and dispatchers, about how to add them onto the list.

But I also understand that workers suffering from mental health injuries need help now. That’s why changes are being made at the WCB right now. With additional staff, more mental health claims are accepted now, in a timely fashion. Support is provided to them as and when they need it because this is in view that health and safety is my number one priority. I will continue to work to make all workplaces in B.C. the safest in the country, and those who are injured at workplaces are treated with respect and dignity.

Supplementary Question

A. Weaver: I might suggest to the minister when he asks how to make such changes, it’s quite easy. It’s through order-in-council. So I would encourage the minister to direct that passion that he talked about to actually ensuring that the workers are given the protection that they need.

For example, a few moments ago, I read the story of registered nurse Bonnie Christie. Her doctor filed a WorkSafe BC claim and referred her to a psychiatrist who confirmed the diagnosis. But the WorkSafeBC process to evaluate her claim took four months and made her relive the traumas time and time again.

This is what Bonnie says:

“The core problem I had with WorkSafeBC is that nursing isn’t one of the occupations that presume mental disability because of work trauma. To get my claim accepted, I had to retell my story over and over to WorkSafeBC” — a story that I told you a few minutes ago. “Every time I retold it, I relived what I went through. During that time, I was crying all day long and had so much anxiety I couldn’t leave the house.“

My question is to the Minister of Labour, when will he ensure that the presumptive clause for work-related mental health disorders is applied to nursing? The trauma Bonnie has experienced is no different — no different — from the trauma that is experienced by firefighters and police officers, professions that are dominated by men, not women. The Nurses Union has provided the evidence to the minister. It’s time for the minister to act. When will he act?

Answer

Hon. H. Bains: I must say that, unlike the previous government, health and safety of workers is my number one priority. That’s why we made the changes. I’m so proud of those changes, and we realize more needs to be done.

The legislation was our first step. It allows me to add other groups of workers onto the list. That’s why we are actively working with those, and I will be meeting with nurses later on today who will be providing me with more evidence of why they should be added onto that list.

So we are actively working with those groups. But WorkSafe is working with those groups right now by adding more staff and helping those people suffering from mental health injuries. I just want to say to the House here as well, that every worker in this province is entitled to mental health coverage through WorkSafe. We are adding more resources to help them as we go forward.

But I am working with nurses. I am working with other groups so that we can add them onto that list to provide them better protection. I want to ensure that all workers go home after the end of their shift safe and healthy.

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.

Today in the legislature I rose to speak at second reading to Bill 43: Miscellaneous Statutes (Minor Corrections) Amendment Act, 2018.

This bill corrects a number of very minor errors in legislation that have been found over the years. Such miscellaneous statute amendment bills are considered house keeping bills that contain numerous minor changes to several existing pieces of legislation.

Below are the text and video of my not to be taken too seriously comments on Bill 43.

Text of Speech

A. Weaver: It gives me great pleasure to rise and speak in favour of most aspects of Bill 43, Miscellaneous Statutes (Minor Corrections) Amendment Act, 2018.

Unlike the member for Vancouver-Langara and the Attorney General, I do believe one of the changes is very controversial, and I will come to that at a later point. Perhaps maybe I should…. Well, I’ll come to that at a later point.

This bill, like previous miscellaneous statutes bills, corrects a number of typos and errors. It’s truly remarkable that some of these have been found. I’m amazed at the level of service we have here in British Columbia — for example, the change in Assessment Authority Act, the first section, No. 1, in this bill. What it’s doing in this change…. Somebody caught the change of December 31 and suggested it be changed to December 31 — 31 to 31. I literally couldn’t tell the difference.

I asked my colleague the member for Saanich North and the Islands, and he couldn’t tell the difference. My colleague the member for Cowichan Valley couldn’t tell the difference. The Minister of Health couldn’t tell the difference. So what I had to do was ask the Attorney General. The Attorney General pointed out that he was advised that, in fact, the number 1 was not a number 1 in the first December 31; it was the small case for the letter “l.”

Now, there’s just no way you can tell that. I have no idea, because they are identical, how somebody was able to find that. That person, if that person reports to the Attorney General, needs a pay raise, because this is just unbelievable, the level of accuracy in our legislation.

You know, I think I’m going to pull across right to the very controversial section at this phase, and that is section 21 in this bill. Now, it is controversial at its fundamental level. What section 21(b) says here…. Well, the first part’s not. Section 21 is a change to schedule C. It says, “in the description of Coste Rocks Parks by striking out ‘1 hectares’ and substituting ‘1 hectare'” instead. Now that, I agree, is not controversial. Clearly, “one” is not plural, so it is correct, actually, to have the singular form of hectare.

However, look at the second change, that “BC Hydro Plan plan” should be changed and struck out and replaced with “BC Hydro Plan.”

Now, I remember in the leadership debates, in the lead-up to the last campaign, that there’s a very subtle difference between the word “plan” and the number you use. I remember accusing the B.C. NDP at that time of having a plan to develop a plan to come up with a plan on MSP reform. I asked the now Premier in the leadership debate: “Is what you’re saying that you have a plan to develop a plan to come up with a plan?” He responded: “Yes.”

Here, we’re talking about a B.C. Hydro plan plan. So I’m not so sure that we can so glibly assume that this is a minor correction in light of the fact that maybe we need a plan for a B.C. Hydro plan and maybe we need a plan to come up with that plan to develop a B.C. Hydro plan. I look forward to exploring this at committee stage, and I do ask the Attorney General to bring in senior officials from B.C. Hydro to justify the use of the removal of the word “plan” in its second case there.

We move forward in this. Of course, there are some important changes, like we see in section 2. Heaven forbid we leave “local” un-italicized. That’s been corrected. Thank you. Section number is incorrect. That’s very important.

You know, this is shocking. This one is really shocking. Not as shocking, actually, as the fact that in section 1, the error in having the small case “l” instead of the number 1 has been in place since 1980. For 38 years, we have had December 3″l” — small cased — and not December 31 — 38 years.

Do we have to go back and look at every reference in our history of law here to whether that was invoked and ensure that it was invoked correctly? But no….

Interjection.

A. Weaver: Wonderful.

The good news here is the changes are applied retroactively to 1980, so we’re safe.

In terms of another issue that was really troubling to me — it’s troubling to me that this actually happened — under the 16 years of rule by the B.C. Liberals, I would have thought that they’d have recognized the difference between American spelling and Canadian spelling.

Here we have in the Clean Energy Act — an act brought in by the previous government — the use of the word “fueling” with a single “l,” instead of a double “l.” It’s unacceptable for a representative of Her Majesty the Queen to be using single l’s in the word “fuelling” and “fuelled.”

What’s next? Is “travelled” going to have one “l”? Is “modelling” going to have one “l”?

Interjections.

A. Weaver: What’s happening to our English language here in this Legislature today? I sympathize with the members opposite who are saying, “Shame, shame,” to this.

Interjection.

A. Weaver: Even the Liberals have two l’s, as pointed out by the member for Penticton, who’s really not supposed to heckle from the back when he’s not sitting in his chair, but I liked it. Thank you for that.

Moving forward, we have a couple of changes here, where “an” was inadvertently written, and “a” has replaced “an” to correct it. I totally appreciate that. There  is, actually…. I’m surprised we haven’t spawned a delegation from the province of Quebec. I’m concerned that we haven’t actually seen the francophone society of British Columbia up in arms about section 7 where the accent ague was left off économie. Instead of saying économie, it’s “economie.” What are we saying to our French British Columbians when we are so lackadaisical that we don’t take care of the application of the accents? It’s just outrageous, shocking, but I’m glad that it’s being fixed.

There are a few more examples, where “an” was changed to “a” — very important. We’ve got a typo here — a typo that I make myself sometimes. In section 12, we see the International Commercial Arbitration Act has an important spelling mistake. They spelled “usable” as u-s-e-a-b-l-e  — a classic error — and it should be u-s-a-b-l-e. Anyone who plays Scrabble will  know that that’s a no-no, trying to get rid of your extra “e,” no less.

We have others, in terms of the Local Government Statutes (Housing Needs Reports) Amendment Act, we’ve got a missing “R” there. The “S.B.C.” was supposed to be “R.S.B.C.” Who knows what they were referring to with “S.B.C.”?

We’ve got some renumbering of sections in section 14, a small addition in section 15. We’ve added the word “provisions” in section 16. It says here: “one or more of this Act.” Who wrote that? Who wrote this Mortgage Brokers Act so that it just said: “one or more of this Act”? What does that mean? Thank heavens we now know what it means. It’s actually “one or more provisions of this act” — a critical, critical addition that ensures that we actually are accurately dealing with this.

I’m really pleased to see the Parental Liability Act was updated. Heaven forbid we didn’t italicize the letter “y” in front of “young offenders.” That clearly has misled British Columbians. There’s another in the Water Act that wasn’t italicized. There are many of these.

Another one that, frankly, I think is quite shocking — I believe this is from the dark era of the 1990s. In the Resort Municipality of Whistler Act, there’s an incorrect use of the word “which” instead of “that.” Thank goodness that the people who review legislation have caught the more appropriate use of the word “that” instead of “which.” I am glad to see that that is changed here.

Most of these are pretty pale. Again, coming back to the egregious error by the B.C. Liberals with respect to the two l’s, even in 2004, they were making that mistake, where they started talking in the Wildfire Act of “fuelling” with a single “l” instead of a double “l,” and “fuelled” with a single “l” instead of a double “l.”

With the changes, I’m sure that grammaticists from north to south and east to west, not only in British Columbia but across our beautiful nation, subjects who revere the monarchy will recognize that these changes are actually at the essence of what it means to be Canadian.

With that, I do thank the minister for bringing them forward. I’m particularly grateful that some of these are brought forward retroactive to the year 1980, two retroactive to the dark ages of the 1990s and 1997 and one to 2016.

The only thing I feel sorry for in this debate is that I don’t get to listen to the comments and the remarks from the member for Nanaimo, who went and got himself elected yesterday and now appears not to be coming back to this Legislature.

I do thank the minister for bringing this forward. With all seriousness, this is important work that our legislative team does. It’s important to have bills that are factual and correct. Obviously, I support this. I commend the work that’s done to find that, particularly…. A pay raise for the person that found the “l” instead of the “1.” That one was a toughie.

Video of Speech

Today the voting packages start getting mailed out for the 2018 refendum on proportional representation. My colleague Sonia Furstenau and I released a joint media statement on this topic. It is reproduced below.

Media Release

B.C. Green Caucus statement on proportional representation referendum
For immediate release
October 22, 2018

VICTORIA, B.C. – Andrew Weaver, leader of the B.C. Green Party, and Sonia Furstenau, spokesperson for electoral reform, issued the following statement on the beginning of the referendum on proportional representation.

“Proportional representation is a chance to give British Columbians a greater say in what goes on in Victoria,” said Weaver.

“Pro Rep will deliver a Legislature that actually reflects how people voted. This means that governments under proportional representation are much more representative and responsive to the views and desires of citizens.

“Our province and our world are facing major shifts, manifesting in challenges like technological automation, climate change and growing inequality. Proportional representation will make it easier for citizens to get engaged in the entire political process, including running for office. One of my greatest hopes is that proportional representation will inspire more young people to run for office and to get elected. The decisions we make today will have a far greater impact on the youth of our society than on anyone else – they deserve more seats at the table and I believe prop rep will make that a reality.”

Furstenau emphasized that proportional representation leads to more collaborative, cooperative democracy.

“With the first minority government in 60 years, British Columbians are getting a chance to see the benefits of collaboration in action. Just one year into our Agreement with the B.C. NDP, we have gotten big money out of politics, made historic investments in education and child care, taken action on the housing crisis and are eliminating MSP premiums.

“Proportional representation will enable us to shift away from a combative, hyper-partisan majoritarian system to one where politicians are required to work together. This means elected officials can focus more on policy outcomes, rather than simply on scoring partisan wins. Voters will feel the benefits the first time they go to cast their ballots under Pro Rep. Proportional representation will end strategic voting, because it gives people a chance to vote for what they want, instead of against what they don’t want. It will end the cynical vote-buying in swing ridings, and greatly mitigate negative campaigning because politicians will no longer be playing a zero-sum game for all of the power. Voting ‘yes’ on prop rep will lead to a healthier, kinder democracy, which in my view believe is exactly what the world needs right now.”

-30-

Media contact
Jillian Oliver, Press Secretary
+1 778-650-0597 | jillian.oliver@leg.bc.ca

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.