Today I had the distinct honour of addressing delegates to the 67^th Annual General Meeting and Convention of the Association of Vancouver Island and Coastal Communities (AVICC) in Nanaimo. As noted on their website, the AVICC

“… is a body formed for the purpose of representing in one organization the various municipalities, regional districts and other local governments of Vancouver Island, Sunshine Coast, Powell River and the Central Coast.“

The AVICC has 51 member municipalities, districts and local governments from these regions. Below I reproduce the text of my speech.

Text of my Speech to the AVICC

Please let me start by thanking the Association of Vancouver Island and Coastal Communities for granting me the opportunity to speak with you today.

The last time I addressed the AVICC was at the 62^nd AGM and Convention on April 8, 2011 at the Mary Winspear Centre in Sidney. I spoke as a UVic-based climate scientist on the challenges and opportunities associated with global warming.

If someone had told me then that I would be standing before you five years later as the MLA for Oak Bay-Gordon Head and leader of the BC Green Party, I would have told them that they must be crazy.

But here I am. And here we are.

Ultimately the reason I got into politics is probably very similar to the reason why you got into politics.

I cared deeply about my community and I wanted to do what I could to better it for present and future generations.

I was profoundly troubled by the direction this province was heading.

I could no longer stand on the sidelines and watch the dismantling of British Columbia’s provincial leadership on the climate change file as our government pursued an utterly unrealistic fossil fuel windfall from a hypothetical Liquefied Natural Gas sector in a desperate attempt to win an election that nobody thought they would win.

Well we are already seeing these promises unravel as the province chase a falling stock, doubling down and selling out future generations along the way. And I’ve been saying the same thing now for more than three years. The market did not, does not and will not, any time soon, support a BC LNG industry anytime soon.

Rather than chasing the economy of the last century we should be positioning ourselves as leaders in the 21^st century economy.

We have a unique opportunity in British Columbia because of three strategic advantages that we have over virtually every other region in the world.

1. Our high quality of life and beautiful natural environment attracts, and retains, some of the best and brightest from around the globe —we are a destination of choice.
2. We have a highly skilled work force. Our high school students are consistently top ranked — with the OECD specifying BC as one of the smartest academic jurisdictions in the world.
3. We have access to renewable resources — energy, water, and fibre — like no other jurisdiction. We have incredible potential to create a clean, renewable energy sector to sustain our growing economy.

But for British Columbia to actually capitalise on our strategic advantages, we must ensure we protect them.

A quality public education is not the luxury of a strong economy. A quality education is what builds a strong economy.

A Loraxian approach to resource management does not protect our renewable resources, natural environment or build public support. We need to move away from the professional reliance model and ensure our regulatory framework is complied with and enforced.

And we must start thinking about the long-term consequences of our decisions, decisions that put people, rather than vested interests or re-election goals first and foremost.

We should be using our strategic advantage as a destination of choice to attract industry to BC in highly mobile sectors that have difficulty retaining employees in a competitive marketplace.

We should be using our boundless renewable energy resources to attract industry that wants to brand itself as sustainable over its entire business cycle, just like Washington and Oregon have done.

We should be setting up seed funding mechanisms to allow the BC-based creative economy sector to leverage venture capital from other jurisdictions to our province.

Too often the only leveraging that is done is the shutting down of BC-based offices and opening of offices in the Silicon Valley.

And following the recommendations of both the B.C. Mayors Climate Leadership Council and the BC Climate Leadership team we should continue steadily increasing emissions pricing.

By doing so we send a signal to the market that incentivises innovation and the transition to a low carbon economy.

And the BC Greens have a plan about what to do with the revenue. The funding would be transferred to municipalities across the province so that they might have the resources to deal with their aging infrastructure and growing transportation barriers.

By investing in the replacement of aging infrastructure in communities throughout the province we stimulate local economies and create jobs.

By moving to this polluter-pays model of revenue generation for municipalities, we reduce the burden on regressive property taxes.

Stable, local jobs give rise to vibrant, resilient municipalities. Yet, building strong municipalities is about more than making smart economic choices at the provincial level.

It is also about ensuring that municipal governments are empowered to make the investments their communities need. It is about asking ourselves: “How do we finance our municipalities now and how might we better finance them in the future”.

It’s critical to immediately initiate a provincial dialog on the future of municipal financing. There is far too much downloading and deregulation that is putting increased pressure on municipalities.

Whether it be dealing with the failure of issues that fall under provincial or federal jurisdiction, pressures on municipal spending through the introduction of regulations that they have no control over, programs paid by municipalities for which they have little control over costs, or the cancellation of funding of programs that are still require to be offered, municipalities are often left on the hook.

Take an issue that affects everyone here. Coastal communities often need to step in to clean up derelict vessels. They often bear the cost of the clean-up even though it falls in the jurisdiction of higher levels of government. This is a glaring example of a dereliction of duty exhibited by both provincial and federal governments.

Is continuing to burden homeowners with property tax increases year after year really the best approach?

Or, could provincial and municipal governments instead work together to create a more progressive financing system that promotes, instead of impedes, the type of fundamental economic activity that we all value, such as buying a home.

It’s also critical that we bring the typically urban-based tech and rural-based resource sectors together. Innovation in technology will lead to more efficient and clever ways of operating in the mining and forestry industries.

I was recently told the story of a BC-based technology innovator partnering with a local mine to dramatically improve the efficiency and environmental footprint of their mining operations.

Rather than hauling thousands of unnecessary tonnes of rock to a crusher for processing, the new technology allowed the rocks to be scanned for gold content on site. This meant that prior to trucking, the company could determine if it was more cost-effective to simply put the rock to one side for use as fill later.

We should be investing in innovation in the aquaculture industry, like the land-based technologies used by the Namgis First Nation on Vancouver Island who raise Atlantic salmon without compromising wild stocks.

These are just a few of the many ideas that could help us move to the cutting edge in 21st the century economy.

Fundamental to all of these ideas is the need to ensure that economic opportunities are done in partnership with First Nations. And that means working with First Nations through all stages of resource project development – from conception to completion.

The Green Party of BC is a solutions-oriented party — one that fundamentally believes that policy should flow from evidence. I like to call this evidence-based decision-making, as opposed to what happens too often in politics today — decision-based evidence making.

We have a vision of a compassionate society that lives within its means while preserving the environment around us. It is a vision that guides us to think about the long-term consequences of the decisions we make today.

If you’ve been watching the BC Greens in the Legislature over the last three years you’ll see I’ve tried to offer government solutions to problems that are facing all of us.

As I learned in my scientific career, and as I tried to teach my students, criticism is easy. But what’s more difficult, yet far more valuable, is being constructive in one’s criticism.

If you don’t like my idea, tell me what you would do instead. That is the approach I have taken in the legislature. That is the approach of the BC Greens.

MSP reform, housing, affordability, and sexualized violence are issues that we’ve been able to make significant progress on this year.

I believe that the BC Greens have helped to shape the narrative and in a not insubstantial way have been strong agents of change on these files.

Most recently it was announced that another one of my private members bills is supported by the government — a bill requiring responsible pet ownership.

So what are the essential traits of a successful leader? I firmly believe is that it is being principled, honest, authentic, trustworthy and having integrity.

Leaders must have the courage to be honest with British Columbians about the risks and consequences of any government decision.

Leadership builds public opinion – it doesn’t follow it.

In the shadows of the massive challenges that we face, our province needs new leadership.

Leadership that offers a realistic and achievable vision grounded in hope and real change.

Leadership that places the interests of the people of British Columbia — not vested union or corporate interests— first and foremost in decision-making.

And it’s not only today’s British Columbians that we must think about, it’s also the next generation who are not part of today’s decision-making process.

We need leadership that will build our economy on the unique competitive advantages British Columbia possesses, not chase the economy of yesteryear by mirroring the failed strategies of struggling economies.

Leadership that will act boldly and deliberately to transition us to 21st century economy that is diversified and sustainable.

Yes BC needs leadership. But leadership doesn’t just rest with one person. Everyone here has the opportunity and responsibility to take this mantle of leadership on.

Leadership means inspiring others to act in ways that contribute to the betterment of their society.

We are all here because we believe BC has the potential to show this leadership.

I hope to offer that vision and that leadership to the people of British Columbia over the coming years and I look forward to working with all of you to make that a reality.

The fact is, very few of the important challenges facing our society can easily be placed within the traditional left-right political spectrum.

Addressing these challenges requires us to come together from across the political divide. It requires us to cooperate and collaborate across all levels of government. And it requires us to develop a social license before, not after, a policy pathway is chosen.

I’m asking everyone in this room to consider working together to find real solutions to the important problems that face us today —problems in affordability, homelessness, poverty, climate change, education and health care.

To conclude, I leave you with what Stephen Lewis stated at his UBCM speech in 2012. He noted that British Columbia has the most lunatic political culture in Canada. Everyone laughed.

But quite frankly, I think we should all have been ashamed.

We can do better. We will do better. And I commit to you today, on behalf of the BC Greens, we will to do our best to work with you to solve the challenges each and every one of your communities face.

Thank you and thank you to the AVICC for giving me the opportunity to present to you today.

Today in the legislature I had the great pleasure of introducing Denis Canuel. Denis runs a professional gardening business here on southern Vancouver Island. He was the recent victim of a vicious dog attack featured in the Saanich News.

Later in the afternoon I introduced my private member’s Bill M212 — Animal Liability Act, 2016. Based on similar legislation in Manitoba, this Bill will ensure that owners of animals are held liable for the actions of their animals. Below I reproduce the text and video of my introduction of the Bill. I append our media release at the end.

Text of my Introduction

A. Weaver: I move introduction of the Animal Liability Act, 2016.

Motion approved.

A. Weaver: I’m pleased to be introducing a bill intituled the Animal Liability Act. Earlier this year a number of vicious dog attacks occurred in the Lower Mainland. Over the years, British Columbians have called on B.C. legislators to act.

According to the Canada Safety Council, more than 460,000 dog bites occur in Canada each year. Just last week, there was a case of unprovoked dog attack reported in Saanich, an attack that nearly left an individual without his employment for years to come. In this case, the dog was a repeat offender.

Here in B.C., we do not have adequate laws that ensure owners are liable for the actions of their animals. Indeed, we only have liability being imposed on the basis of scienter doctrine, negligence or, in some cases, the occupier’s liability act.

This bill would ensure that owners are liable for any damages resulting from harm that the animals cause to a person or property. This bill, based on similar legislation that exists in Manitoba, is designed to ensure that owners of animals take their ownership seriously and are held responsible for the actions of their pets.

I move that the bill be placed on the orders of the day for second reading at the next sitting of the House after today.

Motion approved.

Bill M212, Animal Liability Act, 2016 introduced, read a first time and ordered to be placed on orders of the day for second reading at the next sitting of the House after today.

Video of my Introduction

Media Release

Media Release: April 6, 2016
Andrew Weaver – Legislation needed to ensure responsible pet ownership in B.C.
For Immediate Release

Victoria B.C. – Today Andrew Weaver, Leader of the B.C. Green Party and MLA for Oak Bay-Gordon Head, tabled legislation that would ensure pet owners are held responsible for the actions of their animals.

“Thousands of people are bitten by dogs in B.C. each year,” says Weaver. “While provinces like Ontario and Manitoba have enacted legislation to ensure that public safety is put first, BC is falling behind. We need appropriate measures in place to hold the owners of dangerous pets to account.”

Weaver introduced the Animal Liability Act, 2016, which is modeled on Manitoba’s legislation, to make owners directly liable for any damages caused by their pets. The Bill would not apply to damages caused by livestock.

“As it currently stands, when someone gets bitten by a dog the options available for legal recourse hinge on the dog having a previous history of violence. That’s simply not enough,” says Weaver. “This legislation does not affect the vast majority of caring, responsible pet owners. It targets negligent pet owners who are not appropriately socializing, training, or restraining their animals in public places.”

“In most instances I would expect this legislation to be used in situations where an irresponsible owner fails to take appropriate precautions and their violent dog attacks someone. If someone happened to have a particularly aggressive cougar, llama or emu and they let it run around biting people, however, it would certainly apply,” Weaver added. “We need clear liability legislation so that owners are required to ensure their pets behave safely and are held to account if their pet does behave in a dangerous manner.”

Media Contact
Mat Wright – Press Secretary Andrew Weaver MLA
1 250 216 3382
mat.wright@leg.bc.ca

Introduction

Genetically modified (GM) foods are widespread in Canada, with the potential for further expansion. Though the majority of studies show no negative health effects from consuming GM foods, there is controversy regarding the validity of these studies, and many significant concerns and unanswered questions regarding their effects on the environment.

Background

Genetic Modification (GM) refers to the introduction of new traits to an organism in a way that does not occur naturally, by making changes to its genetic makeup through intervention at the molecular level.

The first GM crops were approved for sale in Canada in the mid 1990s, and they have since become pervasive: they are found in more than 70% of processed foods sold in North America. More than 90% of canola and sugar beets, 80% of corn and 60% of soy grown in Canada are genetically engineered.

While genetic modification can be undertaken for a variety of purposes, including nutrition improvement, virus resistance, and drought resistance, virtually all GM crops on the market today are engineered exclusively for herbicide tolerance or insect resistance.

Herbicide tolerant crops have been engineered to withstand application of herbicides: most common is Monsanto’s “Roundup Ready” corn, which tolerates glyphosate. Crops engineered for insect resistance produce their own pesticides. The most common are Bt crops, such as Bt Cotton and Bt Corn, which are engineered to synthesize Bacillus thuringiensis (Bt) endotoxin in their cells, making them toxic to some insects. Many GM crops are “stacked” with both herbicide tolerance and insect resistance.

There is a strong “right to know” movement advocating mandatory labelling of GM foods in the US and Canada. Polls show that 90% of Canadians support mandatory labeling, and 64 countries around the world have mandatory labelling. Going further, some countries have banned the cultivation of GMOs altogether. Some US states have passed mandatory labelling laws, but a bill is currently under consideration in the US Senate, which would mandate that any such labelling takes place only at the Federal level, and only if health and safety is shown to be at issue.

Some of the Key Issues

GMO foods have been widely consumed for 20 years. The majority of scientific studies undertaken suggest no negative health effects from consuming GMOs (see here and here). However, there are a number of criticisms aimed at these studies, including their short-term nature and the fact that industry funds a large proportion of them.

Some studies have shown negative health effects of GM foods, including toxicity, immune responses, hormonal effects, and allergenicity, but their results are also contentious within the scientific community. Many of the studies showing negative health effects focus on the effects of glyphosate, which the World Health Organization has listed as a probable human carcinogen, and Bacillus thuringiensis (Bt), which are present in GM crops but are also used in conventional, and, in the case of Bt, organic agriculture. It is debated whether the levels at which Bt is found in GM crops are higher or lower than in conventional or organic crops, and whether there are qualitative differences in Bt, with human health and environmental implications, depending on how it is used.

The environmental effects of GM crops are a second key issue. Herbicide resistant plants – so-called “super weeds” – are on the rise, resulting from the widespread use of herbicides, particularly glyphosate. Herbicide use has increased significantly since the advent of GM crops; one study estimates a 15-fold increase between 1996, when glyphosate-resistant crops were introduced, to 2014. Many draw a direct link between herbicide-resistant GM crops and the increase in herbicide use (see here and here, for example). In response to weed resistance to glyphosate, chemical companies are developing new herbicides and engineering crops to resist them, such as 2,4-D resistant corn and soybeans, grown with Dow’s Enlist Duo, which combines herbicides 2,4-D and Glyphosate.

The other major GM crop, modified with Bt to resist insects, has led to a reduction in the use of chemical insecticides in the US (the Canadian government does not track the impact of Bt crops on insecticide use). However, it is debated whether the GM plants have more or less pesticides present than those used in conventional or organic agriculture. Furthermore, since Bt has been used so widely in GM crops, insects are becoming resistant to it, thus farmers may have to switch to other, more toxic pesticides (see here, here and here).

In terms of contamination, GM crops have the ability to contaminate organic farms, which prohibit the use of genetic modification, thereby making organic farming difficult or impossible in regions close to GM agriculture. There is a largely unknown risk of transgene transference from GM crops to wild gene pools: some instances of transference have been reported, but the extent and future potential is unknown.

A Canadian expert panel put together by the Royal Society of Canada noted that the uncertain environmental impacts of GM crops could justify mandatory labeling. Independent research is lacking, as research is primarily funded by industry. The Canadian government doesn’t undertake an independent review process of industry studies on the health and environmental safety of their products before approving them.

Underlying discussions of the health and environmental effects of GM crops is a problem with treating GMOs categorically. Genetic modification is a process that can be used for different purposes and to a wide variety of effects. As noted, while herbicide resistant GM crops are associated with increased herbicide use, pesticide producing GM crops, such as Bt crops, have reduced the use of chemical insecticides. Genetic modification can potentially improve nutrition, such as “Golden Rice” with vitamin A added, or GM potatoes that release fewer carcinogenic acrylamides when cooked; it can make crops virus resistant, by inserting virus proteins into the DNA, as with the GM papaya; and it can help plants become drought resistant, potentially improving global food security. A key point of criticism of mandatory labelling is that it does not differentiate between the types of modification taking place, and their associated effects on human health or the environment.

Mandatory labelling has a significant amount of public and political support, advertised as a means to give customers the ability to know what they are eating. The effect of mandatory labelling on consumer demand is debated: some argue that it will be widely perceived as a warning, thereby decreasing consumer demand for GM products. In response to consumer demand it is predicted that producers will shift away from GM products and source non-GM ingredients. The costs of labelling to the consumer in Canada are debated, but a large study in the US estimated that mandatory labelling would cost US$2.30 per person annually, not incorporating potential behaviour changes.

Another significant issue is the role of chemical companies and large corporations in agriculture. A small number of large corporations exercise ownership over a large and growing amount of food. Farmers cannot save and replant GM seeds; they must purchase them from the manufacturers. There are fears seed diversity will be negatively impacted, impacting food security.

Several Questions

Whereas today GM foods are primarily present in processed foods and animal feed, there is potential for the commercialization of many other GM crops. Efforts are underway to commercialize the non-browning “Arctic Apple”, GM alfalfa, wheat, and some species of fish. What would the effects be of the expansion of the kinds of GM crops being grown, especially for our ability to grow organic produce?

GM crops have only been on the market since the 1990s, so the long-term effects on health and the environment cannot yet be conclusively known. Given the concerns regarding industry funding of scientific studies and the lack of long-term independent studies, many questions remain regarding the chronic and long-term effects of GM crops on human and animal health, and the environment.

Evaluation and Summary

Given the number and the extent of the unknowns associated with GM crops, precaution would suggest, at a minimum, mandatory labelling, an independent, peer-reviewed process to ensure the safety of GM crops before they are approved by government regulators, and long-term, well-funded independent studies on the effects of GM crop on human health and the environment. Mandatory labelling of foods containing genetically modified ingredients would enable people to choose if they want to consume GM foods and support GM technology through their purchases. It would also have the likely effect of decreasing demand for products containing GM crops, moving producers away from sourcing GM crops.

Labelling that specifies the nature of genetic modification (e.g. genetically modified for insect resistance; herbicide tolerance; vitamin A added) would differentiate between kinds of genetic engineering and make the information conveyed through labels more meaningful for consumers. Investigating the extent to which specific labelling is possible, what its challenges and costs would be, and whether there are best practices elsewhere, is suggested.

Industry is a significant source of funding for scientific studies on the health and environmental effects of GM crops, and the Canadian government does not independently review company studies on the safety of GM crops. Funding independent and long-term research on health, environmental, and other effects of GMOs would provide a trusted scientific source of information to inform policy going forward. The establishment of a national research program to monitor the long-term effects of GM organisms was recommended by the Royal Society of Canada expert panel to the Canadian government in 2001, but has not yet been realized.

It seems that many of the strongest motives for concern regarding GMOs come less from an issue with the technology of genetic modification itself, and more from the context in which it is taking place. Regulation and independent long-term research are lacking, and a small number of large chemical companies are driving forward a huge expansion of GM technology in the midst of many uncertainties and unanswered questions regarding its potential effects on our health and the health of our environment.

Let us know what you think.

We were pleased to see a good turn out for our Oak Bay-Gordon Head MLA Town Hall on Seniors and Health Care held on March 29th at the Oak Bay Recreation Centre Sports View Lounge. We were fortunate to receive a very informative presentation from Isobel MacKenzie, who was appointed as the BC Seniors Advocate two years ago. Isobel brings over 20 years of experience working with seniors in home care, licensed care, community services and volunteer services. Isobel led BC’s largest not-for-profit agency, serving over 6,000 seniors annually. It is clear that Isobel is passionate and dedicated to her work. Her presentation was very well received and those in attendance were given an opportunity to ask questions and learn more about the important work undertaken by her office.

There are five mandated areas under the responsibilities of the Office of the Seniors Advocate (“OSA”):

• Health care
• Housing
• Transportation
• Income support
• Personal care

The OSA is an independent office of the provincial government and has several key functions, including analyzing, reporting and monitoring systemic issues that affect seniors. The OSA makes recommendations to government for change and provides information and referral to seniors and their families.

The OSA produces reports, including recently published BC Residential Facilities Quick Facts Directory (March 2016) and a report on Monitoring Seniors Services (January 2016).

More information about the OSA, including programs and subsidies for seniors is available at their website. The office can be reached by phone Toll-Free at 1-877-952-3181 Monday to Friday, 8:30am – 4:30pm (except statutory holidays) or by Email at: info@seniorsadvocatebc.ca

Translation services are available in more than 180 languages.

We will be featuring an interview with Isobel MacKenzie in an upcoming MLA Constituency Report, airing on Shaw Cable April 30, 2016 (8:30am) and May 1, 2016 (10:30am and 3:00pm).

Our sincere thanks are extended to Isobel for participating in our town hall.

With over 4.5 million Canadians in need of a family physician, Canada appears to be facing the largest doctor shortage since the creation of Medicare in 1968. Our practicing physician to patient ratio landed us 17^th out of 21 in a 2006 OECD report on physician services and the situation hasn’t improved since – despite being the focus of many political promises.

a) b)

Figure 1: Percentage of Canadians without a family doctor by age, group and sex aged 12 and over. a) For various age groups; b) Averaged 0ver all ages. Data from Statistics Canada.

Over the last few years, the B.C. Liberals have repeatedly vowed that every British Columbian would have a family doctor by 2015. In 2010 then Health Services Minister Kevin Falcon announced that the Province was going to overhaul its primary health-care system with a $137-million investment to “strengthen service delivery, ensure patients are full participants in their care and provide every British Columbian who wants a family doctor with one by 2015.”

Figure 2: Practicing physicians per one million population for several countries. Repropduced from the OECD report: The Supply of Physician Services in OECD Countries.

In February of 2013 the BC Liberals renewed their commitment with the $132.4 million ‘A GP for Me’ pilot program they said would ensure everyone who wanted a family doctor would be able to access one within two years.

“The objective is clear, all British Columbians will have access to a family physician…” Unfortunately, 2015 has come and gone and there are an incredible number of people still in need of a family doctor.

In fact, fewer British Columbians have a regular doctor now than before the government made those lofty promises. According to Statistics Canada, in 2012 3,397,007 people in BC had a family doctor. By 2013 that number had fallen by 27,947 to 3,369,060. In 2014 it was lower still at 3,361,856.

Despite the incredible amount of money that has been thrown at this problem, today in British Columbia it is estimated that over 200,000 people are still actively looking for a family doctor.

When facing a problem of this magnitude and complexity, it is important to look back at the policies and regulations that got us here. While there are no doubt countless contributing factors that influence doctor shortages, what follows is an overview of the major changes that 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 (source available in hard copy only, page 246). 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 (page 70).

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.

Barer and Stoddart were concerned that there were too many doctors, especially in urban areas, and that this would put people at risk of being over-treated as physicians (who bill per patient) competed for limited cases (page 11, 48-50). This theory of “physician-induced demand,” it should be noted, has always been a controversial and inconclusively proven phenomenon (page 19). Nevertheless, Barer and Stoddart recommended limiting med school entry and reducing the use of foreign-trained physicians and governments followed suite.

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 (page 24). Mandatory retirement caps set at 75 year were removed as well, following a legal challenge by the Senior Physician Society of BC (page 25).

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 a complete reversal. A 2002 report for the Canadian Institute for Health Information, From Perceived Surplus to Perceived Shortage: What happened to Canada’s Physician Workforce in the 1990s?, cited changes to postgraduate medical training programs as the largest contributing factor. By extending the residency requirement for general practitioners there was an extra delay on new doctors entering the workforce. In addition, a higher proportion of medical students elected to specialize, further limiting the number of family doctors (page 36). At the same time more doctors were retiring, fewer students were being accepted to medical school, and the number of positions available to foreign-train doctors dropped – all while the general population continued to increase and get proportionally older.

Five years after the BC government was taken to court for reducing urban doctors billing rates they were back to offering generous financial incentives. Retention Allowances were introduced in 2002 to encourage doctors to start practices in smaller communities. The Northern and Isolation Travel Assistance Outreach Program covered travel costs and accommodation for physicians service isolated communities. In 2007 the Family Physicians for British Columbia program paid $100,000 to doctors willing to establish full service practices for at least three years in underserved areas. That year not one doctor stepped forward to accept any of the 15 Interior Health incentive packages.

Picking up on research that suggests medical students recruited from rural backgrounds are more likely to work in non-urban areas after graduating, the BC government announced plans to expand and upgrade teaching hospitals around the province. They also increased province wide first-year enrollment from 128 in 2001 to 256 in 2007 and authorized the creation of three additional medical campuses at UVic, UNBC, and UBC Okanagan.

Backtracking on foreign-trained doctor restrictions, International Medical Graduates were once again seen as part of the solution to physician shortages across Canada. Canada has never trained enough physicians to meet the country’s needs and foreign-trained doctors account for roughly a quarter of the medical workforce in Canada. Though securing a position is incredibly competitive for non-Canadian doctors, they do account for roughly 38% of Newfoundland and Labrador’s physicians and 46% of Saskatchewan’s. Unsurprisingly, the logistics of integrating and licensing foreign-trained physicians are clumsy and slow, though some medical colleges are recognized as accredited and approved by the College of Physicians and Surgeons of British Columbia which streamlines applications.

In 2007 the college was licensing 100 to 150 foreign doctors per year and in the 2008 Speech from the Throne the BC government promised that a “new framework to allow Canadian citizens trained outside of Canada to find residencies and practices in B.C. [would] be developed and implemented.”

This included a new health profession review board to “ensure that all qualified health workers can fully and appropriately utilize the training of skills and not be denied that right by unnecessary credentialing and licensure restrictions.”

Bill 25, the Health Professions (Regulatory Reform) Amendment Act, introduced in April of the same year provided the legislative structure for these changes

Despite these initiatives the practice of importing doctors is not without controversy and many jurisdictions are trying to become less dependent on them. In 2001 the High Commissioner to South Africa asked Canada to stop depleting the supply of doctors in his country where hospitals were desperately underserved. “Immigration of doctors can ease physician shortages in countries where numbers are lacking but it raises difficult questions about international equity when there are net, long-term flows of physicians from poorer countries with low average health status to richer countries with high health status,” writes Simoens and Hurst’s report on the supply of physicians in OECD counties. “As a result, many OECD countries aim for self-sufficiency in physician supply.”

One possible alternative to the geographically uneven distribution of doctors in BC is the use of “Telehealth” services which use videoconferencing technologies to connect doctors and patients. There are concerns about privacy and insurance coverage with these systems, but the presence of nurses to facilitate calls and operate examination cameras on the patient side do make them feasible in certain scenarios.

The certification of more nurse practitioners is also seen as a promising way to increase patient care while reducing relative health care costs. Nurse practitioners were first regulated in BC in 2005, not as a substitute for doctors, but a compliment. When paired with doctors they can streamline patient care by treating routine illnesses and injuries while physicians handle more complex diagnoses. Nurse Practitioners are able to diagnose, consult, order and interpret tests, prescribe, and treat health conditions. They work in both independent and collaborative practice roles across BC and practice acute care, outpatient clinics, residential care and community settings.

Now at the start of 2016, we find ourselves once again repeating history as we offer doctors a patchwork of financial incentives in an attempt to meet the province’s growing medical needs.

Currently, in addition to recruitment incentives ($15,000 or $20,000), relocation incentives ($15,000), the rural retention program, isolation allowance, and various other training bursaries, rural physicians receive a one-time payment of $100,000 for a commitment to work for three years in a designated rural communities. The incentive is available to family practitioners, specialists and residents who are paid $50,000 when they start work in the community and the remaining $50,000 after one year.

In some situations these economic bonuses have changed the problem, without improving the overall situation. The current set up gives doctors the ability to work less while earning more, and one can hardly fault them for making the most of it. As the graphs from the MSP Physician Resource Report below indicate, the total expenditure for general practice doctors has increased significantly since 2005, but the average number of patients treated per physician has dropped. The government’s policy changes over the last ten years have lead to more doctors, working less days, treating fewer patients. An important, though further complicating, caveat to this data is that it focuses on quantity of care – not quality. In many cases doctors seeing fewer patients is a positive change as it indicates they are spending more time with each individual. For people struggling with multiple or complex conditions this added assistance is essential.

With more female doctors, who statistically allocate more time to each patient, practicing in BC than ever before and doctors in general striving to create a healthier work life balance, the policies used to influence the doctor shortages of the 1970’s are no longer relevant. Family doctors play a vital role in our well being and they deserve a policy framework that lets them treat patients in a manageable, fulfilling, and efficient manner.

Given this province’s complicated history with doctor shortages, what is most concerning about the BC Liberal’s promise to provide every British Columbian with a family physician is not that they have failed – one only has to look back at the struggles Canada has had maintaining an appropriate number of GPs to know BC’s doctor shortage was never something that could be fixed in two years. What is most concerning is that British Columbians were repeatedly mislead about what could be realistically achieved.

We’re beginning to see a pattern emerge with this government. Whether it be promises of 100,000 LNG jobs, a debt free BC, or a GP for every British Columbian, the government is long on rhetoric and short on policy grounded in evidence. British Columbians deserve better. They deserve a government that is transparent and honest with its expectations and promises.

Over the next year, and in collaboration with my policy advisors, I will be outlining ways we might consider to alleviate the British Columbia’s GP crunch.

If you have ideas you would like to share with me and my team, please don’t hesitate to email us at: Andrew.Weaver.MLA@leg.bc.ca