Oral Questions

COST OF LIVING
AND AFFORDABILITY ISSUES

M. Bernier: Look, life has never been more expensive in British Columbia. People
deserve better than what we seem to have, under the Premier’s secret plan. I’m not sure
what he’s doing here to work on inflation, but costs in B.C. are higher than ever.
The latest inflationary data shows that things are getting even worse, not better, here
in British Columbia. With the cost of living now…. It’s jumped up almost 6 percent over
last year. So while the Premier seems to have no problem solving the inflationary
problems for himself and cabinet with a $40,000 raise, he’s doing nothing right now to
help the people who, in British Columbia, are suffering with all these extra costs.
This is what the Premier said last Thursday. “The Minister of Finance has been
directed by me to look at efforts to bring forward initiatives to assist with inflation. Well,
we’ll see how that goes.” That sure doesn’t sound very much like a commitment from
this Premier to do anything. I’ll give the Premier another chance.
What is the Premier going to do now to address the inflationary costs that are
hurting people in British Columbia?

Hon. J. Horgan: I appreciate the question from the critic from Peace River South.
Our objective as members of this House is to make life better for our constituents.
We’ve been, of course, doing that, Mr. Speaker, as you know, since 2017, when the first
order of business was to do away with tolls on bridges that were put in by Kevin Falcon
at the time.
The second thing we did was fix the dumpster fire at ICBC. That led to not one, not
two but three rebates to policyholders as well as a 20 percent reduction in costs. It’s not
just the travelling public that have benefited from these policies. The aforementioned
medical services premiums are gone completely. They do not exist in British Columbia.
Kevin Falcon indexed them annually so they would go up year over year over year.
That was their solution to inflation — to introduce an inflationary tax on regular people.
We’ve done away with all of that.
We’ve reduced costs for child care. We brought in a child opportunity benefit. I
appreciate that the grandmothers…

Interjections.

Mr. Speaker: Members. Members, order.

Hon. J. Horgan: …and -fathers on the other side…. They’re past their child-raising
years. As grandparents, they will know that their children are ecstatic to have access to a
child opportunity benefit. They can raise their kids here in British Columbia with $1,600
more in their pockets.
Again….

Interjections.

Mr. Speaker: Members. Members.

Hon. J. Horgan: Clearly, international inflation is a hot-button issue for the

members from Surrey. They must be just crestfallen that the people that they represent
no longer have to pay tolls to drive around in the Lower Mainland.

Mr. Speaker: Member for Peace River South, supplemental.

M. Bernier: A non-answer from the Premier on what’s affecting people today right
now — a 6 percent increase in inflation. The Premier said that the minister was going to
work on something, but we don’t know what that is — obviously, a secret plan from this
Premier.
Look, house prices have gone up $600,000 under this Premier’s watch. Renters are
paying $3,000 a year more under this NDP government — still no renters rebate.
While the Premier, again, has no problem giving a retroactive pay increase for
himself and cabinet, $40,000, think about this. Nearly half of the people in British
Columbia are only $200 away from not being able to pay their bills every month.
The NDP took care of themselves, but they weren’t able to take care of the renters
with a renters rebate. They’ve done nothing to lower housing prices, which they
promised to do. Now it looks like they’re just going to skirt over and do nothing to help
with the inflationary pressures that are hitting the people of British Columbia today.
Will the Premier be more specific about now, what he’s going to do now? What
direction has he given the Minister of Finance, and what will British Columbians see that
will help them today?
[2:05 p.m

Hon. J. Horgan: Again, I know that this is a fact-free zone when it comes to the
official opposition. They know full well the compensation rates have not changed at all
in British Columbia. They’re the same now as they were before.
They’re the same now as they were before.

Interjections.

Mr. Speaker: Members.

Hon. J. Horgan: I appreciate that’s difficult for them to understand.

 Interjections.

Mr. Speaker: Members.

Hon. J. Horgan: I appreciate that they would prefer to rely on stunts from the
Preston Manning era, rather than good government. Fair enough.
I commend them to review a book written by one of their former colleagues, George
Abbott, who talked about the yanking back and forth of tax policies that was under the
watch of the other guys, all for a stunt. Instead, we’re focusing on people.
I absolutely understand the challenges and the hardships that people are facing as we
come out of a pandemic that constrained economic activity across not just the province
but the country and, indeed, around the world.
Only B.C. Liberals would be so filled with hubris that they would think that British
Columbia is the only place that’s experiencing inflation right now. It’s not. This is a
global phenomenon…

Interjections.

Mr. Speaker: Members.

Hon. J. Horgan: …that does not require the narrow thinking of B.C. Liberals but
expansive thinking like that on this side of the House, focused on making life better for
people rather than scoring political points with misinformation.

Mr. Speaker: Members, please. When a question is asked, the other side listen.
When the answer is given, the other side listen. Let’s pay attention to each other.

P. Milobar: Here in 2022, when people are faced with $200 left in their bank
account and not being able to pay their bills, the Premier had no problem rushing his
retroactive pay, which, in fact, will see a cheque in his bank account long before any
relief is seen for people with their rebate cheque around the price at the pumps. The
Premier has repeatedly promised to make life more affordable, but he just simply hasn’t.
Under the NDP, housing and rents are up at record levels. The cost of gas has
doubled. In fact, gas is around 50 to 60 cents more expensive in B.C. than it is in
Alberta, where it gets shipped from to B.C. The cost of groceries is up almost 20 percent.
On Thursday, the Premier said: “The minister has been working on inflation initiatives
for months, and will continue to work on it for the days ahead.”
Working on it. No actual solution and no deliverable. There are families who don’t
know how they’re going to pay for their groceries tomorrow morning, yet the Premier
and this government are dragging their feet trying to bring forward any actual
meaningful results for people.
 Will the Premier be clear? What is he going to do about inflation, and when will
they actually do it?

Hon. S. Robinson: Well, I know that the members do understand — I actually do

think they understand — that this is a global issue. There are many people around the
world in many jurisdictions around the world that are worried about rising costs for
necessities like food and housing. It’s especially hard on people who are struggling.
There’s no doubt about that.
The federal government and the Bank of Canada have the tools to combat inflation
directly, and our government has always been committed to reduce costs for British
Columbians. We’re going to continue to do that very important work.

Interjections.

Mr. Speaker: Members.

Member for Kamloops–North Thompson, supplemental.

P. Milobar: Well, there are jurisdictions around the world and around this country
that are actually trying to take meaningful action at the same time.
The fact is that life has never been more expensive as it is now under this NDP
government. People are paying more for everything. Beef and butter are up 32 percent.
Fresh vegetables are up 24 percent. And gas — almost 70 cents more a litre under the
NDP.
While the NDP cabinet has had no problem acting very quickly to give themselves
that raise — a retroactive raise, I might add — the Premier refuses to even say when he
will help British Columbians. In fact, this is what he said last week. This is how little
urgency they have on this subject. This is what the Premier said last week: “I don’t want
to say we’ll have something to say in a few weeks, because then the questions will start
tomorrow.”
People need help now. They need answers now. They don’t need to wait a few more
weeks to maybe, possibly, find out the government is going to have nothing to say.
Again, what is the Premier going to do, and when is he going to do it? People are
$200 away from not paying their bills every single month. They can’t wait.

Hon. S. Robinson: Well, instead of giving tax breaks to the wealthy and large
corporations, we’ve been using that money to help average British Columbians.
[2:10 p.m
We have a child opportunity benefit, up to $133 a month in people’s pockets; and
$500 off of their car insurance, on average, after we cleaned up the dumpster fire.

Interjections.
 Mr. Speaker: Members.

Hon. S. Robinson: And you know what’s going to happen this year?

Interjections.

Mr. Speaker: Members, please.

Hon. S. Robinson: This year, by the end of the year, a 50 percent reduction in child
care fees, which is huge for families.

ACCESS TO FAMILY PHYSICIANS AND ROLE

OF URGENT AND PRIMARY CARE CENTRES

S. Furstenau: The family doctor crisis in our province is top of mind for a lot of
people right now. There are 900,000 British Columbians without primary care. Those
who are with it are finding their access increasingly cut back, and 40 percent of British
Columbians are afraid of losing their family doctor.
This government has opened 27 urgent and primary care centres as their solution to
this crisis. They’re quick to open them, but many lack funding plans and adequate
staffing. They’re open limited hours. They fill up quickly, and there is gatekeeping over
who can use them. They’re meant to deliver care for people who are in urgent need.
They are demonstrably not the solution for the family doctor crisis. The minister said as
much on CBC radio last week when he said: “While urgent care is important, the key
thing is to build access to primary care.”
My question is to the Minister of Health. We hear that there have been one million
visits to UPCCs, but there are two other numbers that are essential for understanding the
complete picture. How many of those million visits were to access primary care, and
how many people have been turned away from UPCCs?

Hon. A. Dix: Since 2018, the government has pursued a primary care plan, which
seeks to reform primary care in our province by building team-based care in every part
of our province. The principle initiative has been what’s called the primary care network,
which supports existing primary care providers and expands their capacity to attach — in
other words, to serve more patients in a longitudinal way over a number of years and
visits but also to provide better access to urgent care.
So 54 primary care networks, which represent the lion’s share of the new staff that
have been added, which is 950 across British Columbia…. Yes, 27 urgent and primary
care centres have served over one million people. During the pandemic, those urgent
primary care centres were essential in British Columbia because of the absolute
transformation of our primary care system that happened on a dime in 2020. They have
played a central role.
 They’re not the only part of the plan. We have added new community health centres.
We’ve added new residency positions. We’ve added dramatically — I mean dramatically
— three times the number of nurse practitioners serving in primary care than have ever
served before. This is an effort to do that. We have to continue to do that, and we will.

Mr. Speaker: Leader of the Third Party, supplemental.

S. Furstenau: I think there’s an interesting trend that we see with this government,
particularly when it comes to health care, which is a lot about the inputs but not much
about the outcomes.
We have gone from 700,000 unattached patients in this province to 900,000
unattached patients. We’re hearing doctors talk about leaving their practices because the
burden on them is too great when they’re dealing with fee-for-service and having to run
a small business in addition to caring for their patients.
I applaud the minister’s sense of urgency, but I think what we have to start
measuring are the outcomes. I didn’t get an answer to my question about how many
people have been turned away from UPCCs and how many people that visited UPCCs
were actually accessing primary care.
My question, again, is to the Minister of Health. How many British Columbians
have been attached to a family doctor through a visit to an urgent and primary care
centre?

Hon. A. Dix: The member speaks of outcomes. I’d just say this. This is a
transformation that’s occurred on fee-for-service. In addition to that, we have added the
number of APP doctors, alternate payment doctors, in the amount…. It’s 15 percent a
year in each of the last three years — 15 percent a year. We are transforming the system.
[2:15 p.m
The member is right. This is primarily a fee-for-service system, unusual in Canada
— that 80 percent of primary care billings are fee-for-service. That has happened over
time, over multiple governments. That’s where we are today — 80 percent.
During the pandemic…. Talk about the response of the primary care system and the
response of the government. In 2018, there were over 16.5 million primary care visits. In
2021, in the full year during the pandemic, there were 18.43 million.
Now, that was a dramatic increase, but it hides the real story, which is that we had to
and family doctors had to, on a dime, change the system such that there were over
647,000 virtual visits in 2018 and 13 million virtual visits in 2021. This transformation
has happened, and it has had a significant effect, including on patients, many of whom
struggle with the lack of in-person visits.
This has been an extraordinarily challenging time, and I want to acknowledge the
exceptional work done by family practice doctors and others. But in that context, the
million in-person visits at UPCCs have been incredibly valuable, and I don’t think that
criticizing them is the right approach. They are part of the answer. No one ever said that
they were the whole answer. I don’t agree with that.

Interjections.

Mr. Speaker: Members.

Hon. A. Dix: At a time we needed more in-person visits, we delivered a million

through UPCCs. That was important, and I want to thank everyone in the system —
doctors, nurse practitioners, health authorities and the Ministry of Health — for the work
they’ve done together to serve people in the most difficult of times.

ACCESS TO FAMILY PHYSICIANS

AND PRIMARY HEALTH CARE SERVICES

S. Bond: We need to be very clear about something. No one in this House is

criticizing the unbelievable work of health care professionals across British Columbia.
No one.
To the minister’s point about what’s dramatic, here’s what’s dramatic. Nearly one
million British Columbians do not have access to a family doctor, and somehow that’s
acceptable to the minister. British Columbians want a relationship with a family doctor.
It is shocking to think that, in British Columbia, one in five British Columbians — a
number that has, by the way, dramatically worsened since 2017 — have no family
doctor.
The minister tells them to go to a walk-in clinic. Well, guess what we discovered.
This week we discovered that British Columbia has the worst wait times in Canada at
walk-in clinics. The average in Ontario is 15 minutes. It is two hours and 41 minutes in
the Premier’s backyard. At 8:20 this morning, every single urgent and primary care
centre in Victoria was already at capacity and not taking patients. The only walk-in
clinic left had a four-hour-and-30-minute wait time. This is simply not good enough in
British Columbia.
The minister can spout numbers all he wants. What British Columbians want him to
do is work to ensure that they can have a relationship with a family doctor.
What exactly is the Premier going to do about the fact that one in five British
Columbians have no access to a family doctor or are waiting hours in line at walk-in
clinics?

Hon. A. Dix: There were a series of statements said by the member. I was referring
to the criticism of UPCCs, not of health care workers, for members of the opposition.
She made a series of statements that she put in my words that I’ve never said and that I
don’t believe. I’m not sure if that’s helpful to the debate, frankly. I just disagree with it. I
just say that frankly to the member.
 What I would say is that what is required in our primary care system is significant
reform. We have, in B.C., an unusual primary care system. We have one that is more
fee-for-service than anywhere else. We have more people coming to British Columbia
than from anywhere else. And how have we responded? We’ve responded with a very
significant investment in team-based care such that there are 950 more people working
in primary care networks, 300 of them in urgent and primary care centres across the
province to provide more service to people.
[2:20 p.m
We’ve just been through a more than two-year pandemic, so far, that’s changed
primary care more than any other part of health care, more than acute care and more than
long-term care, in fact. We are working our way through that. I would say that, in that
period, we’ve added more than 600 family practice doctors. We have the largest family
practice residency program in Canada. That’s because we added 60 new positions since
2017.
We have to continue to do this work together, because I agree. Access to
longitudinal care, particularly for those with chronic diseases and those who are older, is
absolutely critical. That’s a priority for this government. It’s been a priority for me from
the beginning, and it continues to be now.

Mr. Speaker: The Leader of the Official Opposition, supplemental.

S. Bond: Well, the minister makes it sound like he just figured this out yesterday.
This is a two-term, half-decade government.
British Columbians are concerned. In fact, many British Columbians feel hopeless
that they will ever have the ability to have a family doctor under this government’s
leadership. People feel hopeless.
Let’s listen to the words of Jacqueline Brand, who said: “I don’t have a family
doctor anymore since the James Bay clinic closed. I am 73 years old. I need my
prescription filled. I need it soon, and I don’t know where to go.”
Here’s what we do know: one in five British Columbians do not have a family
doctor. The minister says: “Go to a walk-in clinic.” They wait for hours. Our numbers
are the worst in the country.
In fact, when the Premier was asked about this issue last week, what did he do?
What he typically does. He blamed Ottawa. It is long past time….

Interjection.

S. Bond: The Premier can laugh and shake his head. It is not funny to the one in five
British Columbians who can’t access a family physician. He should check it out in his
own backyard, as recently as this morning, when they couldn’t get in to an urgent
primary care centre.
 When is the Premier going to do the work that is necessary to ensure that British
Columbians have hope that, someday in this province, they will have access to a family
physician — or have to wait for hours in line at a walk-in clinic?

Hon. A. Dix: Again, the point the Premier was making was a point, by the way, that
his predecessor had made with respect to the Canada health transfer. It’s a point that has
been made that the decision of the federal government, which is a unilateral decision in
2016, to fix increases in the Canada health transfer well below the rate of inflation has an
impact on health care everywhere in the country. The Premier is leading the effort
nationally on behalf of British Columbians and people across Canada. There is a role for
everyone in that process.
When I became Minister of Health, 83 percent of primary care billings were fee-for-
service in B.C. The number was 46 percent in Ontario. That requires a change. It
requires a change because the fee-for-service model, which supports volume, doesn’t
reflect the needs of the increasing complexity of patients. I know the member knows
this. We’ve talked about it many times, we’ve discussed it many times, and she has made
the point many times.
How do we address this? We address this by building out team-based care — 950
new FTEs, full-time people, in primary care networks across B.C. We do it by adding
new models of care, including community health centres and Indigenous and First
Nations–led health centres in British Columbia. We do it that way.
We do it by training and having more residency positions. And we have. We do it by
moving from last in Canada in nurse practitioners to the fastest-growing place, the
centre, of nurse practitioner primary care in the country. That’s how we do it. We do it
by building out team-based care.
This was a significant issue when I became Minister of Health. We’ve just had a
two-year pandemic that was profoundly affecting primary care, and we’re continuing to
work at it with our partners in the system: doctors in British Columbia, health
professionals in British Columbia and communities in B.C.

B. Banman: B.C. has the longest wait times in the country by far. Ontario has
figured it out. Their wait time is 15 minutes.

Interjections.

B. Banman: The opposition can think that’s funny. I don’t think people standing in
lineups for hours think it’s funny.
B.C. was the only province to see an increase. The wait times are now up over 50
percent on this NDP watch.
[2:25 p.m
Wait times are skyrocketing, clinics are shutting down, and doctors are leaving their
practices. We have a system that is under crisis underneath this NDP government.
 In Maple Ridge this morning, the Cottonwood Medical Clinic was at its capacity,
and a clinic just down the street had a wait time of three hours and 30 minutes.
Willowbrook medical centre, in Langley, had a six-hour-and-30-minute wait time.
That’s not acceptable under anybody’s watch.
Why, Mr. Premier, have you abandoned people to hours-long wait times to get the
medical attention they deserve?

Hon. A. Dix: I’d remind members of the House that there is an important aspect to
episodic care that we have to address. We have, in part, done that by adding those
million visits to urgent and primary care centres in B.C., including one in the member’s
area, in the member’s hometown, which has had — I have to tell him — a significant
and profound and positive effect on people in Abbotsford during the pandemic.
In respect to the survey that he cites, it’s a partial, not a comprehensive, survey and
by a private company. Fair enough. I think people are…. This is my view always: any
significant wait for health care is too long for me. It’s why we’ve done surgical renewal
on surgeries. It’s why we have a primary care plan. It’s why we’re supporting long-term
care. It’s why we’re adding residency positions. It’s why we’ve significantly increased,
almost doubled, the number of nurse practitioner positions in the province, including
those working in the member’s constituency.
It is a challenge for people in B.C., the question of a family practice doctor,
particularly in circumstances where their doctor is aging out and retiring, and those
people who’ve been with that doctor for 20, 30, 40 years find themselves without a
family practice doctor. That’s why we are responding in the way that we are.

T. Halford: Dr. Tahmeena Ali was named B.C.’s Family Physician of the Year in
2020. She provides incredible care to the people of South Surrey. Now she says she’s at
a breaking point, and every day she says she’s on the cusp of quitting. “We are hurting in
family medicine, and this community is hemorrhaging members daily.”
Instead of blaming the federal government, will this Premier stand in this House
today and commit to do something and get British Columbians, the one million British
Columbians who are today without a family doctor, the care that they desperately need?

Hon. A. Dix: I think it’s fair to say that the Premier and the government will
continue to lead the country with respect to the Canada health transfer. I don’t think that
is inconsistent. That is one aspect of how you deal with challenges with respect to
primary care.
How do we do that? We add primary care networks and team-based care, 950 new
FTEs. That’s significant. We significantly increased the number of nurse practitioner
positions. The creation of nurse practitioner positions was the work, on the government’s
side, of George Abbott, when he was Minister of Health. It was the work at that time.
But when I became Minister of Health, we were last in Canada in terms of the number of
nurse practitioners working. We’ve profoundly changed that. That’s how you do it.
 In South Surrey, in Cloverdale, there’s a nurse practitioner–led clinic. That’s how
you do it. You build primary care networks. You build opportunities for people who
work, and you increase the number of residency positions in family practice.
Now, there are challenges. The fee-for-service system for new entrants into the field
who generally want to practise medicine and don’t want to run small businesses is a
challenge. Our existing system is generally based on that, and the new entrants in the
system don’t want to do that as much, meaning that they are and tend to be much more
attracted to hospitalist positions or alternative payment situations.
Those are issues that we have to work on with family practice doctors in B.C.,
including Dr. Ali, to ensure that they are supported in the outstanding work they do in
communities.

Mr. Speaker: Member for Surrey–White Rock, supplemental.

T. Halford: The minister’s words are not met by action from this government, from
this Premier, and we see that day after day. Every member of this House is getting the
letters, the emails, the phone calls, the visits, saying: “We need help. We do not have a
family doctor. We need support.”
[2:30 p.m
Every riding is getting those calls. The minister can dismiss them. The minister can
rattle off numbers. At the end of the day, a million British Columbians are without a
family doctor, and that is unacceptable.
Dr. Ali says: “Our cries are not being heard. Family medicine is hemorrhaging. We
are an endangered species, and without us, the primary care system is going to fall
apart.” A system that the minister spent most of this question period talking about. This
doctor is saying it’s at critical mass, and this minister continues to dismiss these issues.
In Surrey, 13 walk-in clinics are full by 10 a.m. Thirteen walk-in clinics are full. If
you want to take your child to get support because you don’t have a family doctor, you
can’t visit that walk-in clinic if you’re not there by 10 a.m. This minister thinks that this
is acceptable, this day in this province — a million people without a family doctor.
When will this Premier step up in this House and give British Columbians the
assurance they need that they will be supported by a family doctor?

Hon. J. Horgan: I just want to correct some misstatements by those on the other
side.
First and foremost, there is one person that’s working 24 hours a day to improve
health care for people in British Columbia, and it’s the Minister of Health. Everybody
knows that.
Secondly, at no time have I blamed the federal government.

Interjections.
 Hon. J. Horgan: They don’t want an answer, hon. Speaker, because they are part of
the problem. That’s why.
The opposition characterizes cooperative federalism, making our country work by
ensuring that there’s adequate….

Interjection.

Hon. J. Horgan: Do you want to hear it, man? Do you want to hear it, or do you
just want to hear your voice? Why don’t you go in the bathroom and talk to yourself in
there? You don’t want to hear answers in this place. Seriously.
The Canada health transfer is fundamental to health care in British Columbia. It’s
fundamental, and it has been for generations.

Interjection.

Hon. J. Horgan: Do you really care, or do you want to hear yourself? Do you want
a headline, or do you want action?

[End of question period.]

Interjections.

Mr. Speaker: The bell ends the question period.

Interjections.

Mr. Speaker: Members, seriously.

Interjection.

Mr. Speaker: The Leader of the Official Opposition will come to order.
The House will be in recess for ten minutes.

The House recessed from 2:33 p.m. to 2:34 p.m.

[Mr. Speaker in the chair.]

Mr. Speaker: Calling the House back to order.

Interjections.

Mr. Speaker: Members. Members, I think the question period is over.

 I’m so disappointed in all of you. During the question period, I have repeatedly said:
“Please listen to the question and listen to the answer.” Once that’s over, don’t make it
personal. Let’s behave like adults, please.

Interjection.

Mr. Speaker: Member for Nechako Lakes. What was your point, Member? You are
just challenging the Chair?

J. Rustad: My apologies, Mr. Speaker.

Mr. Speaker: Members, I have the honour to….

T. Stone: Mr. Speaker?

Mr. Speaker: Member.