Bill M219 — Health Authorities Amendment Act, 2025 (continued)

As I close the debate on Bill M219, I want to return to the principle at the heart of this legislation. No one in British Columbia should die waiting for care without being empowered with information. This bill is about bringing openness into health care, making sure that no barrier, no delay and no lack of communication stands between the patient and the information they need to make an informed decision about their own care. When time matters most, having clear information can be the difference between fear and hope, life and death. The bill is built on four simple principles — transparency, respect, compassion and accountability. Transparency means patients deserve to know how long they’ll wait and when options are available when care is delayed. For a vast majority of patients, not knowing adds an incredible amount of anxiety and suffering for patients and their families. Respect means treating patients as partners in their own care — informed, empowered and given a chance to act. It’s about respecting the health care workers who dedicate their lives to patient care. Compassion means remembering the human side of this crisis, the suffering behind a wait-list, the fear of the unknown and the heartbreak that follows when tragedy strikes. Accountability means mandating real action, tracking and reporting so that we can see where our health care system is failing British Columbians and work together to fix it. I want to thank the members of this House who have spoken during this debate, the MLA for Langley-Willowbrook, who navigated cancer herself when health care was timely. I’ve also heard from families, from nurses and from my colleagues in medicine, patients and people who have lived this pain firsthand. They’ve told me about loved ones who waited months for cardiac surgery that never came. I heard about mothers who learned too late that their cancer had spread. A 2024 study of ovarian cancer pinpoints the fact that if more than 30 days pass between diagnosis and treatment, the five-year survival drops from 54 to 32 percent. That’s a staggering statistic. Imagine being a young mother navigating our medical system with ovarian cancer, not knowing if she is going to be seen in time. Every story is different. Some have managed to get timely care, while others have not. Unfortunately, the reality on the ground is that too many patients and their families are not getting the information they need until it’s too late. The data is there or how would this government make the decision to send women with breast cancer to Bellingham for radiation treatment? They need to share this data with patients. We also know that part of this crisis stems from a health care workforce stretched beyond its limit — doctors, nurses and specialized professionals working themselves to burnout. Their dedication is extraordinary. This bill is one of the steps we can take to ensure that patient care and access are not compromised by the staffing crisis. Transparency can help bridge the gap as capacity catches up so that no patient is left waiting without answers as the system rebuilds. Our duty on both sides of this House is to protect all British Columbians. Let us unite around a shared duty. Let us say together that no one in this province should die waiting for the help that never came. Transparency alone will not heal our health care system, but it’s one part of the repair and the foundation upon which access can improve for every British Columbian. Let’s give everyone in B.C. the dignity of knowing where they stand in their care. Bill 219 is about empowering patients and saving lives.

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Bill M219 — Health Authorities Amendment Act, 2025 (continued)

When my colleague asked me to speak to her private member’s bill, I was in the middle of working with Lyndsay Richholt. You will recall that she’s a 42-year-old mother in my riding in Kelowna Centre. Lyndsay is an incredible human with a beautiful family and a tenacious spirit. Although patient and willing to wait her turn, Lyndsay was running out of time in her wait on B.C.’s transplant list. Despite being her own best advocate, Lyndsay was getting almost nowhere until her local MLA went public. As someone who has always believed that we need to advocate for ourselves in the medical system and who has been a patient advocate, I do believe that the need for advocacy has reached unacceptable levels. In fact, there are too many examples of impossible advocacy. If you can advocate until you’re blue in the face but there are no available services for your needs, then your advocacy is, in fact, impossible. At a time when — actually, correction — 4,620 British Columbians are dying in one year on a wait-list, we have to ask ourselves: do we even value the sanctity of life anymore? No one in a civilized, compassionate society should die while waiting for surgery or diagnostics, but 4,620 British Columbians did. That’s double the amount of overdose deaths in B.C. in one year. We are outraged over the amount of overdose deaths, and we see the evidence of this tragedy in all of our respective downtowns. But the truth is that we have a silent epidemic that is much deadlier, and no one is talking about it. We owe it to British Columbians to bring these facts to light and to have the conversation. The purpose of Bill 219 is simple and practical. It lays out exactly what a patient can expect and would need to know. First, patients will be told exactly how long they have to wait. No more wondering if it will be six days, six weeks or six months. The patient will be told exactly if their wait time is unsafe or unreasonable for accessing their care. And third, this bill will achieve transparency. By sharing real wait times versus the recommended wait times, a new plan can be developed in all the cases where wait times exceed recommendations. This bill will inform the patient they can make a choice to travel outside their health authority or province to access the necessary care, rather than just waiting. This bill restores transparency, respect, compassion and accountability to a system that desperately needs that. So this bill shares medically recommended timeframes, it sets clear evidence-based timelines for diagnostics and treatment, and it gives patients something they’ve been missing. No more waiting in the dark. It requires notification when timely care is not possible, and patients must be told when their wait times become unsafe. Here is the beautiful part. They must be given real choices, including care outside their health authority, care outside the province and alternative pathways or providers. I believe it’s beautiful because it restores informed choice, puts the patient first and in the driver’s seat. It restores the patient to a place of helping to choose the path forward for themselves. It restores dignity. Contrast that with my friend Lyndsay, left in the dark on wait times, calls not being returned, and then, when she called, she was treated adversarially. There is no dignity in that. This bill ensures transparent reporting of deaths on wait-lists. Health authorities must report when a patient dies waiting for a specialist or a diagnostic or for a surgery. The minister must publish an annual public report. These numbers can no longer be buried or minimized. So what does this mean for patients and families? Patients gain the right to know: how long will they wait when delays occur, and what are their options? No more being left in the dark, this restores dignity for families who currently feel invisible. Communication becomes a right, not a privilege. I believe this is a step in the right direction, a way to restore confidence and build back trust. Isn’t that what everyone wants? No one wants to be kicked when they’re down and that is what it feels like for far too many British Columbians in the health care system these days. For health care workers, it supports the overworked professionals by making communication a system responsibility, not an added chore for them. Doctors and nurses want patients to be informed. This bill helps the system catch up to their professionalism. It provides data that helps target resources and reduce burnout. Transparency means clear publication of benchmark wait times for diagnostics and treatment. Accountability means tracking where delays are happening; reporting deaths; and, most importantly, acting on the data. This bill forces the system to confront bottlenecks instead of hiding them. I think we all know what it’s like to get behind on something, to be embarrassed by it to the point of hiding it. Whether it’s a late bill or a late homework assignment or that dinner that you promised a friend, knowing that you’ve failed in a responsibility or a promise is a highly uncomfortable situation. I know. I had a particular situation that taught me a valuable life lesson. When I was a young mom with young kids, I was behind in a bill and I was avoiding the other mom that I knew I owed it to. Finally, she confronted me and developed a plan with me to make it work. There was no judgment in her confrontation, just collaboration. There was so much freedom in that moment. A plan to deal with the backlog brought freedom to both the one who was owed and the one who owed the money. That’s powerful. This bill seeks to bring freedom, power and connection back to both parties — the patient who needs the care and the system that owes the care. And that includes the front-line workers who want to provide the care and want to do it well. Why this matters: wait times are worsening across nearly every category; staffing shortages continue to grow; doctors, nurses and more than 70 specialized professionals are stretched to exhaustion. When the system is strained, honesty becomes essential, and sometimes that’s counterintuitive. Honesty is the only way forward. I recently wrote an article entitled “When Waiting Becomes a Death Sentence.” In it, I talked about how as Canadians we have a Stockholm-type syndrome love affair with our system. It’s ingrained in us as Canadians that we have great health care and that it’s free and that the only way to talk about it, the only acceptable way, is with gratitude. But on the contrary, the truth is that we pay nearly $19,000 in taxes for each year for a family of four. We also wait for services. We wait in the ER. We wait in the referral queue. We wait for diagnostics. Many of us will die waiting this year. We must begin a much more honest conversation about health care in B.C. that includes all of the uncomfortable facts. British Columbians deserve clear information, clear options and clear responsibility. This bill ensures patients are informed, supported and respected because timely information is part of informed care. Every life has inherent worth. This bill recognizes that patients are not numbers. They are humans deserving of honesty and dignity. All humans deserve care in a timely manner. All British Columbians deserve to be given other options if that care cannot occur in a timely and local fashion. Today I invite all members to support a bill that strengthens transparency, builds trust and honours the people that we serve. Bill M219 does not cost compassion; it restores it. It ensures that British Columbians are never again left waiting without answers, without options and without respect. It’s time to choose accountability, dignity and the sanctity of life.

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Bill M219 — Health Authorities Amendment Act, 2025 (continued)

I rise today to speak to Bill M219, the Health Authorities Amendment Act. While transparency in health care is important, this bill does not solve the problems that it claims to address. Instead, it risks making life harder for patients, it adds layers of administrative burden and bureaucracy to front-line workers, and it opens the door to privatization. Under this bill, health authorities will be required to notify patients when they cannot receive care within a medically recommended time frame. But what does that actually mean in practice? It means that someone in a health authority is spending their time on this administrative task rather than focused on supporting the patient with the medical care that they need. Bill M219 provides no guarantee of faster care, no additional resources, no new doctors, no new nurses. For patients, this is not a solution. At a time when we are working to reduce administrative burden for physicians through meaningful legislation, such as the recent employment standards amendments aimed at reducing the requirements for doctors to write sick notes, this bill adds new layers of administrative burden onto physicians and health authorities, which reduces time available for local care coordination, exacerbating system strain. This bill creates systemic inefficiency, and it risks duplicating existing frameworks. This bill ignores the fact that cancer care, cardiac services and transplant services already have provincial oversight. This bill threatens to interrupt and impact existing provincially coordinated services. Cancer care in B.C. is coordinated provincially by B.C. cancer care, with support from local health authorities. My family is experiencing this. We were into the system and experiencing timely care really soon after our diagnosis, and that was just this summer. So some of the statistics and stories that were just mentioned from across the aisle should be taken with a grain of salt, because they are not reflective of everyone’s situation. Cardiac Services in B.C. already manages specialized cardiac care and wait-lists provincially. Assigning cardiac referral services and responsibilities to the health authorities risks disrupting this highly effective coordination. B.C. Transplant services oversees organ donations and transplant services across B.C. Shifting transplant coordination to health authorities could impair provincial wait-list management and monitoring. Adding to the duplication of services, out-of-province and out-of-country care is a service that is already available to patients in British Columbia. This determination is already delegated to the Medical Services Commission, which outlines the criteria for out-of-country and out-of-province medical care. Residents who are enrolled in MSP may use medically necessary services in another province or territory under these guidelines. We know that demands on health services have increased exponentially in recent years due to COVID-19 pandemic, climate disasters, population growth and aging population. This requires our regional health authorities to coordinate more efficiently and effectively. This is why we are working tirelessly to reduce wait times with proven strategies, not political gamesmanship. Adding mandatory reporting, compliance requirements and ministerial oversight will divert time and money away from front-line care. Every hour spent filling out forms is an hour not spent treating patients and is resourcing work away from the front line. Finally, the most troubling aspect of this bill is the risk of privatization. This bill allows health authorities to suggest options outside the region when they cannot meet timelines. What does this mean in practice? It means patients may be encouraged to seek private care or go out of province if they can afford it. This undermines the principle of our universal access and creates a two-tiered system where those with means jump the queue while others wait. For communities like the riding of Ladysmith-Oceanside, where many of the residents are retirees on a fixed income, this is not a choice. It’s legislated inequity. I am reminded of how undermining the two-tiered education system is in British Columbia to a robust public education system, when those that can afford it, those without complex learning needs, can simply pay for an alternative that does not accurately reflect the demographics of the communities where they live. This government knows that there is work to do to improve health care in British Columbia. We know that British Columbians deserve real solutions, and that is what we are working on — investment in workforce recruitment, expanded surgical capacity, better regional autonomy to innovate and improved timely access to primary care. Bill 219 offers none of these. It offers optics, not outcomes. The member from Vancouver Island north referenced the Fraser Institute during her opening. That reminded me of the school ranking system published annually by the Fraser Institute. The Fraser Institute says that this creates transparency in education by providing families with information to ask questions and create change in neighbourhood schools. However, after 27 years of ranking schools, the Fraser Institute cannot point to one school or one neighbourhood that has had a positive outcome as a result of these rankings. What can be attributed to this ranking system are real estate agents using them to woo families with means, into and out of certain neighbourhoods or schools, and a lot of wasted time every year in the education system explaining why the rankings are not reflective of the good and effective work happening each year in schools. The member opposite just quoted a stat about the number of people who were waiting for medical care that died in B.C. I have to say that I don’t think it’s reflective and appropriate. My dad died waiting for care, but he was 82. His heart was the size of a walnut. There were multiple options that could have happened. There were many reasons why he passed away, and most of it had to do with his heart being old. This list and these numbers that they’re quoting are not reflective of the complexity associated with people who are seeking medical care. Let’s not let our health care system go down the same path that has happened with the privatization of our education system. We’re focused on solutions and not optics, and for these reasons, I urge the House to reject Bill 219 and instead focus on measures that truly strengthen public health care for all and support our front-line workers in the work that they’re doing.

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Thank you for the reminder, Madam Chair. Independent analyses comparing England and Scotland found that England’s outsourcing of surgical care increased inequality, drawing staff and resources away from public hospitals. One researcher observed: “Private clinics poach staff from the NHS to treat cheaper cases, leaving the public system with more complex cases and fewer resources.” This means the burnout of doctors, nurses, care aides, techs and many other health care workers. Another study linked to higher rates of avoidable mortality to increased reliance on for-profit clinics for publicly funded services. These outcomes did not reduce wait times overall. They simply shifted them, deepening inequality and weakening the universal system. The member for North Island has said public commentary, when she brought this bill forward, helps to illustrate the underlying intent. In discussing wait-time reform, the member argued that we need options within our universal system and pointed to international examples, saying Japan has an older population than Canada but still manages to have no wait-lists. This member also said our health care system is stuck in the 1970s. But the clearest articulation came when the member described what options would mean in practice. Some people will want to pay, so you get them off the list, so they pay from their own pockets. That is not strengthening universal health care. That is defining explicitly a two-tier system. Bill 219 is the mechanism that makes that system possible, first by normalizing notifications, then by normalizing alternatives and finally by normalizing payment as a path to faster care. Research shows that inequality deepens. It does not make health care more accessible. When we talk about health care for all, we mean every single British Columbian, not just those who can afford it. Every MLA in this chamber agrees that wait times must come down. Every MLA agrees that patients deserve information. The real solutions come from addressing root causes, not exporting patients or weakening public institutions. Our approach focuses on strengthening primary care so that fewer people end up needing urgent or specialist care; expanding the health care workforce through sustained investment in training, recruitment and retention; increasing operating room time and capacity, not outsourcing surgery outside the public system; using private facilities only within public contracts under the Canada Health Act without extra billing and without profit from insured services; and improving data sharing and referral pathways so patients move through the system more efficiently and equitably. These actions build capacity. They support clinicians. They respect patients. They strengthen our public system. They do not hollow it out. Bill 219 presents itself as a transparency bill, but beneath the surface, it risks fragmenting provincial care, overwhelming health authorities with administrative burden, shifting medical decision-making to boards and laying groundwork for a two-tiered model of health delivery. Health care is and must remain a human right, not a commodity. No British Columbian should ever have to pay for faster access to medically necessary care, and no legislation should push us in that direction. Our responsibility is to strengthen the public system for everyone, not to create pathways that benefit only those who can afford them. For these reasons, I cannot support Bill 219 as it’s currently written.

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