 Good afternoon, everyone, it's good to see everyone here today, thanks for joining us. I'm Adrian Dix, I'm BC's Minister of Health. I want to begin our event by respectfully and acknowledging the history, the customs and the culture of the Musqueam of the Squamish, of the Slewa Tooth First Nations, on whose traditional lands we meet today. I'd also like to thank and introduce to you Dr. Ramnik Desange, the President of the Doctors of BC for being with us today for this announcement. We're here to talk about primary care, people in BC are seeing and experiencing strains on our health care system, strains caused by the two and a half year public health emergency that is COVID-19 and its effects, extreme weather events, the toxic drug supply, the changing demographics and needs of our province and the people who live here. People are struggling to access the family doctor when they need care. Family doctors are struggling to keep up with rising operational costs, an aging population and the increasing complexity of patients health needs. It's a situation that requires actions and we're working with the doctors of BC to enact transformational long-term changes to the way primary care is delivered in our province. It means actions to retain and attract more family doctors. It means action to ensure that British Columbians have access to high quality primary care when they need it. It means action to work with doctors of BC, family doctors and other partners to find and put in place the solutions that work for all. See in close partnership we are doing just that, finding solutions that will provide not only immediate relief but solutions that will last into the future. It's critical essential work and it demands time and care if we're to get it right. Work is underway on a new compensation model but we know that solutions and supports are needed now. So today the Ministry of Health and the doctors of BC are delivering $118 million in interim funding to support clinics and family doctors right now. The $118 million in interim funding for family doctors throughout BC will help them ensure their patients have continued access to primary care services. This action will help stabilize our primary care system. It will ensure that family doctors can maintain their practices and this action will ensure family doctors can care for their patients as we work together on long-term solutions that renew, build and strengthen primary care in our province. Over 70% of all family doctors working in BC, that's approximately 4,580 family doctors can access this funding. This action on interim funding is key but does not stand alone. It is one part of a multi-phased approach to protect and improve BC's healthcare system in the short and longer term. Today's announcement is one of many solutions that we're working on together. Our collaboration with the doctors of BC will see us develop a new physician master agreement and compensation model for longitudinal family doctors. An agreement we will announce later this year and as we work toward the solution action is ongoing. Discussions are underway and through this general agreements have been made on key components of the new payment model. Agreements include compensation based on the time spent by family doctors in providing primary care services and patient encounters as well as complexity and attachment. Action is underway in developing additional measures that support and improve patients access to primary care. This includes recruitment and retention of healthcare providers and it includes additional resources for increased training capacity. These actions are ongoing and this progress is being made and we will report on our achievements as they are ready to launch. Ensuring British Columbians get the ongoing primary care they need means supporting BC family doctors in the ways that help provide them provide the quality care patients rely on. It's that work and working together on it that will make the difference that patients and their family doctors are counting on. And now it's my pleasure to introduce Dr. Ramnik Dossange, President of the Doctors of BC to the podium. Thank you kindly Minister Dix. I also would like to acknowledge the land at which I'm speaking on, the unceded territories of the Coast Salish, Musqueam and Slewa-Tooth nations. These doctors care passionately about our patients. We want to ensure that nearly one million British Columbians without family doctors get the quality of care they need and deserve. Today's announcement is a first step to help family doctors keep their doors open for patients until we can develop and implement a new payment model. We've heard loud and clear from our doctors that this is a much needed step that we cannot allow clinic closures to continue at the rate they have been. This funding gives us time over the next four months to finalize and implement new payment model that will help us recruit and retain doctors into longitudinal family practice. A new payment model will address rising business costs and also recognize the value of family doctors in the primary care system. It will also acknowledge the time they spend with their patients and the complexity involved in providing this type of longitudinal care. I want to thank all of our doctors, my colleagues, who are continuing to provide this level of care for their patients at such a challenging time. I want to acknowledge and my heart goes out to all those patients suffering for their needs because everyone truly does deserve a family doctor. We have a lot of work ahead of us to achieve longer term solutions to help the primary health care system in this province but I do believe that we are one step closer into getting there. Thank you. Thank you. Thank you very much, Dr. DeSanche. Family doctors are the foundation of our primary care system and supporting family practice clinics is the core of the province's primary care strategy and the commitment it makes to patients. It is at the core of the primary care networks for building 59 of them across BC with more to come. This interim funding will provide the immediate support and stability our family doctors and patients count on and will ensure the continued delivery of care for people in BC. Working with doctors of BC, family doctors and other partners, we will build upon and strengthen primary care services for patients, taking the short and long-term actions required to ensure certainty and confidence. I'm now happy and Dr. DeSanche and I are happy to take your questions. Thank you, Minister. A reminder for reporters on the phone to press star 1 to enter the queue is to cost a question. Please remember to take your phone off mute. You will not be audible until your name is called. For media in the room, please indicate if you have a question and wait to be called. If there is a microphone available please stand at the microphone and make sure it provides you full name and outlet. Our first question is in the room. We will go on to Penny Daven is okay. Hi doctor I just want to start out with a question for a colleague if someone's listening to the announcement right now they don't have a family doctor what does this announcement do to help them get one and how does this help family doctors who are feeling really burnt out right now well it's one step in the process one of the reasons I think family doctors feel burned out to talk about the family doctors first is the pressures in the system including issues of overhead right so if you look in a general sense you see the those pressures on the system are real and they put existing practices in jeopardy in many cases so what this is is a first step to stabilize the system while we build a new compensation mark model designed to increase entachment and to provide better care to patients so it's good to stabilize the system that's necessary and this money will do that effectively over the next four months it provides a hundred and eighteen million dollars which is essentially if you look at the numbers in general it's in this range 25,000 in some cases slightly more per doctors if you have a doctor practice with four doctors in it that would be a hundred thousand dollars as an example so this is an important announcement that stabilizes the system that addresses a key question of overhead that has been raised by family doctors with us and it impacts the patients and citizens who are the patients of those family doctors today so that's critical point one it allows us that a little bit of breathing space and support for family doctors it also demonstrates our commitment to a new funding model a new model for primary care that will be better for patients and encourage more people to to be part of full summer family practices so that's an important step and it's a first step and you'll see in the coming days and weeks many other steps to increase both the access to the number of primary care providers you know we've added well over a thousand in our primary care networks in the province and we'll continue to be continuing to take those steps but this is a necessary first step it reflects the dozens and dozens of hours that we've been working with doctors of BC in this in recent months to address some of these fundamental questions I think it's fair to say that our primary care system which developed over a long period of time that model no longer meets the needs of patients and meets the needs of doctors so this is a demonstration tangible action right now that brings immediate relief to family practices and that's good news for patients and for doctors penny did you ever follow it I do and this is a question for me you've often expressed pride in BC's surgical renewal plan and catching up on postponed surgeries but the latest research from the Canadian Center for Policy Alternatives suggests that at least some of that is happening at the enrichment of private companies so I'd like to know how is that providing value for taxpayers well let me start because you're asking about the the report we saw today I think it's fair to say that the suggestion that we're silently supporting private health care is wildly inaccurate based on the facts facts that are publicly available and widely available on line and you know we would have been happy to provide accurate information have we've been approached to do so just put in context health authorities contracted in 2021 27.2 million to private clinics that's 0.23% so 0.25 of 1% of the 11.8 billion health authorities reported spending in acute care in the same period in 2020 21 there were 13,863 contracted surgeries that's 4% of the total so one out of every 25 surgeries the the report also refers to diagnostics 296,211 MRI exams in 2021 22 that's an increase an astounding increase all in the public system contrary to what the report says of 120,000 it is a spectacular performance in that time we increase the net new 17 new MRI machines in the public system well the number in the private sector which are providing non-medically insured MRIs went down so I think the example of the last few years is we've dramatically increased the number of MRIs and why did we do that for the very reason I think the authors of the reporter talking about that if you allow people go outside the system then come back inside the system got an MRI that creates a sense of two-tiered health care so we've changed that this is a radical change we went from last in the country to close to the top of all the provinces in Canada by investing in the public system we purchased three private MRI companies and the money we spent to purchase them is included in here as expenditure on private health care I think that I think it's fair to say that's an accurate that's not an accurate reflection we've engaged in surgical renewal 400 trained new surgical nurses 100 new medical device technologists a dramatic 84 measures to increase the capacity not of the private system but of the public system this has been a period of remarkable increase in growth of the public system in public responses to surgery I put patients first and the government puts patients first we do do a small number of surgeries in the private with private clinics none of them are extra billed they have to comply to have a contract with us with a Medicare Protection Act and the Canada Health Act and that's a significant change from the period of the previous government there's a discussion of Falls Creek Surgical Center which is really the only substantial sort of allegation the report well people forget that we cancelled their contract because they wouldn't follow the law and then they were sold they came back into compliance and their contract was renewed the previous first part of that story is not described here right that's what we did I think that's the right thing to do because you got to put patients first and I think if you're waiting for surgery you want to be publicly paid you want to be part of the public health care system and that's what we do the numbers that are used to describe diagnostic care what can I say 300,000 MRIs not one private contract that's a public system that has dramatically increased public sector solutions public solution to public issues and ironically its recommendations made by organizations like the BC Center for Policy Alternatives that we've systematically put in place so I'm very proud I mean the real story is a dramatic increase in the delivery of those services it's why we reduce surgical wait times in a pandemic we weren't ideological about it but our position is patients first one and two that the best solutions are in the public system and that's what we've been delivering for our next question we're going to go to the phones Rob Shaw from check please go ahead hi there I'm getting used to this check the amount the specific amount 118 million the 25 thousand average for doctors how was that amount settled on and how sure are both of you that that's enough you know it was settled on and discussed during a summer of work and I think when family doctors came and doctors decided was one of us to meet with us a number of months ago but we talked about some of these issues so if you look at it in a broad sense one of the concerns expressed is that if a doctor becomes a hospitalist in a hospital and doesn't pay costs for example overhead costs then effectively they are paid significantly more than someone who is working in longitudinal family practice and full-service family practice and so what this does for this period is addresses dress that particular issue and ensures that our family doctors are assisted in these times while we deal with the new model of compensation that we're developing together so I think you know time always tells but this is a significant investment 118 million dollars for four month period to support our family doctors I think it reflects the work we've done together and I think it will provide some support as we as a first step as we work through these issues so I think I think it reflects the work we've done and the effort that's been put in I want to acknowledge all of the work done by senior officials of the Ministry of Health led by Deputy Minister C Brown and all of the people working in the doctors of BC but I think this reflects a very significant investment that will support family doctors on issues of overhead Rob did you have a follow-up sure and maybe could also hear from Dr. Defange on that question as well but the follow-up is could you give us some examples of the operational business cost that this covers and just can we make sure like does it include could a doctor use it to compensate themselves within that 25,000 could they up their own salary or is it only for certain types of costs maybe you could outline what those are so so first of all and doctors the Sun's will talk about it what this is is per doctor twenty five thousand dollars because these operational costs exist right they exist for every doctor and they are paid for it generally through fee for service billings right so the net salary or the net compensation for a doctor is what they are compensated minus their operational costs that they're paying so this is twenty five thousand effectively and it would be slightly different for different doctors but that's basically what it is per doctor to provide direct support in this period so it reflects overhead but it is essentially a direct payment that will go through clinics all those doctors so it's not a complicated proposal the money is going to go out it's going to be allocated doctors will have there will be a process for doctors to apply and the if they do apply and they go through the process in September the money will arrive in October just to address your question this funding again is a temporizing measure it's an interim solution to help stop the bleeding our family doctors are finding it more and more difficult as the increasing costs of rising costs of business and we know that most family doctors in their clinic the operational cost is between 30 to 40 percent and sometimes higher so this funding allocation is for the period between October 1st and January 31st it's a way to keep those doors open and to have our patients not suffer and to not add to the nearly one million patients without a family doctor and we have to recognize as Miss Daffloes said earlier about the burnout about our physicians on the ground we have to recognize in order for them to keep their doors open and to keep up with the business cost that this is a temporizing measure but we are working on a new payment model which is to incentivize more family doctors to be able to keep them retain them in family medicine as well as recruiting our new physicians to family medicine we need to incentivize for all of the work that they've been doing and value the time that they spend with their patients and the complexity and the ability to provide this type of care any further questions our next question is for Katie to Rosa Vancouver son hi there thanks for taking my question I'm what do you say to doctors who might say that their staff is so burned out that you know having to apply for this grant is just one extra thing that they're you know have on their plate and again considering 25,000 is sort of a small amount considering the high overhead costs will this be enough to actually incentivize people to not leave the profession Katie $118 million from now to January 31st 2023 is not a small amount it's a substantial contribution many doctors if you're looking at a net overhead cost you have it as I say a practice with say eight doctors that's $200,000 overhead for for that period of time so it's a significant contribution I think and it's been worked out to together as part of the work that we're doing together to address these fundamental issues so I think that the characterization of that is it's just not correct this is a very significant contribution that has been developed on a proposal is developed not just by us but by us meaning the Ministry of Health and the doctors of BC to make things better in the short run as we do what we need to do which is fundamental change which includes a series of measures that aren't about compensation for family doctors but also includes issues of how we compensate family doctors a system that is BC system which hasn't changed and fundamentally it hasn't some significant areas in particular since 2017 for the better but it doesn't change fundamentally in a long time so you know I'm I just don't agree with the characterization of $118 million is a small amount it's a significant amount and it contributes and it demonstrates as a first step the actions that we need to take together the way it was developed demonstrates it the fact of it demonstrates it the size of it demonstrates our commitment and our our view of the need to reform and to reinvigorate a system make it truly a primary care system for the 21st century and in that the doctors of BC and the government our partners Katie did you have a follow-up yes and with the negotiations around the C for service I mean that's been going on since May so can can either Dr. DeSange or Minister Dix explain what's the hold up is there a perhaps a stall or is there a disagreement or you know yeah where why can't we have that agreement sooner considering how dire this is well first of all we're as you might be aware have the physicians master agreement which is a specific negotiation is one of many negotiations are taking place including public sector negotiations right now this one involves us not just negotiating in a classic sense but working together to deal with fundamental issues around compensation for doctors I spoke to it and Dr. DeSange spoken to it in in our in our preliminary comments but what it means is transforming that system and in the meantime taking steps to assist patients and doctors right now and that's what this is doing and so I don't think it's taking a long time quite the contrary but we're taking the action necessary working together to to make sure that that happens and you have to get it right it's important to get it right because the consequence are high but our commitment is demonstrated by both the size of this of this action today and the way it was developed developed in partnership with the doctors at BC I'm very proud of the work we're doing together and it demonstrates I think to people that that effort pays off for them as well next question is for Richard dustman global news please go ahead for the minister and Dr. DeSange I know there's a lot of pressure on family doctors it's alleviate some of it a lot of the other potential ideas on the table is handing over some prescription powers to pharmacists is that something that's being considered by the provinces part of these more overarching changes that could be coming and Dr. DeSange would family doctors support the idea of handing over some of those prescription powers in order to have more time to see patients with more complex needs well I think I think what I would say is this is today a major step to stabilize our system of family practice that will help patients and help doctors it's not the only step issues around scope of practice are very important and obviously all of those issues are on the table but today we're announcing this and I'm sure we'll have more to say on those other issues I mean issues around scope of practice and team based care in a general sense in the coming in the coming weeks but I would say on this question on this question today this is an important step forward but there will be other steps we have to ensure that everyone in the health care system contributes to the maximum extent they can we've built with doctors with divisions of family practice primary care networks across the province and it well now well over a thousand new FTEs a very significant number of those FTEs our pharmacists a significant number of those FTEs our mental health and addictions professionals and close to 200 of them incremental in that period and because that is what family doctors and communities needed and and proposed and so we're going to continue to work on team-based care and building out team-based care making it sure everyone works to the full extent of their abilities and that's what doctors are going to do but you know I would say Richard one announcement at a time Richard do you want me to echo this sentiment I do believe that we need to work alongside our pharmacist and like minister Dick said to the scope of practice as well as facilitating our team-based care however or prescribing and giving other options at this time is not the way to do things we have a crumbling foundation of our primary care system and that is what we need to support robust support for those docs that are bleeding on the ground those family docs that can't keep their clinic doors open because of the rising cost of business that's imperative but we do look for alternative solutions and leaning on all of our allied healthcare professionals to support the care that's done in the community I think we need to acknowledge that our patients matter doctors are more concerned about our patients and their well-being and the access and attachment for those patients in our family medicine clinics is of priority this step in the funding is also a temporizing measure for the next four months to hold those clinics over while we are devising this new payment model which within it will hopefully give more options and ability for family physicians to provide the type of care that they went to medical school for they are the clinical experts in diagnosing and treating them and we need to be able to create opportunity for them to be able to practice the way that they were always meant to practice and that's with ample support from all of our allied healthcare professionals but also bolstering support for newly graduating physicians that are coming into the practice I hope that answers your question Richard did you have a follow-up when it does answer the question thanks Dr. Sascha and this is from minister Dix back to the report the penny was asking about earlier I know you disputed a bunch of the content in there one of the things in the report shows uh this is the question from a colleague despite evidence that private clinics drain resources from the public sector and evidence from government auditors that at least two private clinics were double billing why would contracts with those facilities are renewed well I don't think it was part of the answer earlier to Penny's question but in the case of Falls Creek Surgical Center which was the main focus I guess of what was being put forward that's exactly what happened we we have asked every private clinic that performed surgeries the four percent of surgeries that are done through private clinics to follow the Medicare Protection Act and to sign this and follow the Canada Health Act and they've all agreed to do that when Falls Creek Surgical Center initially didn't want to do that and wasn't following it their contract was cancelled and that's exactly what we need to do we've taken further action than that though which is to buy a couple of surgical centers because that has allowed the doctors and nurses and others working in those surgical centers as part of the public health care system to do more surgeries which is what we want to do but we're putting patients first and that's why we have dramatically increased the public system through surgical renewal by putting in place the specific actions 84 of them in the public system to expand access to public services to dramatically increase our capacity by training more anesthesiologists for example by putting in place a replacement and it's been put in place an alternate payment model for anesthesiologists put in place in many parts of the province now that's moved away in their case from fee for service and on diagnostic care I mean it is just not accurate to say when we've increased the number of public MRI exams and that's even more with respect to CT scans from 174,000 the last year the Liberal government to almost 300,000 during a pandemic this is an exceptional increase and how have we done it by dramatically adding the number of public MRI machines by dramatically using the machines we have in a very significant way so there's only one machine in the province that went 24-7 before I think the number is now nine we've got 18 MRI machines that operate 17 hours a day seven days a week and the results are startling and they're a success for the public system and so and to draw any other conclusion or do a report that talks about diagnostic care and MRI and not say you know that the number of public MRIs has gone up dramatically number of private MRIs has gone down dramatically and to say that that is the corporatization of health care is just not accurate and you know that we can always have a debate about these things and people are allowed to to have their point of view and opinion but but you know there isn't much substance to this and the substance shows that this is the public health care system doing what it should do you know on surgeries we've gone in many important surgical categories according to the Canadian Institute from Health Information now for me from near the bottom to at the top knee replacements and hip replacements and MRIs are in that category and I think we should be very proud of that and it wasn't me that did it it was the doctors and nurses and health sciences professionals and health care workers who did that work and made it happen I'm very proud of them and the final thing I'd say is it's always patients first it's always patients first and the best way to serve patients is to build a public health care system that's precisely what we did and what we've been doing and what we're going to continue to do and and so you know I think that people may want to make a point but I think unfortunately the evidence is overwhelmingly uh goes in another direction our next question is for Graham let's glacier media please go ahead with regard to the growth trajectory of these private surgeries or private clinic surgeries you said four percent are you looking to flatline that growth do you want to bring that down to zero or is there a place for these contracts in the future moving forward and and do you see through the growth in them well you say four percent and talk about growth three we just purchased two of them so the numbers will go down and I expect them to go down but but look when you're a patient waiting for care waiting for a surgery you want to get that surgery as soon as possible I'm the minister of health and I'm telling you that's what we put in place 84 measures to increase surgeries during a pandemic and reduce the wait lists for surgery during a pandemic which I have to say is an exceptional achievement of our surgeons of our surgical nurses of our medical office administrators who had a big part in that work of the health sciences professional do pre and post surgery work with patients it's an extraordinary success and so that number is going down but but I think and it's my conclusion that having a small number of surgeries that increase our capacity that as long as they follow and there's no extra billing and follow the Medicare Protection Act I don't think I have any objection to that and in fact we've continued that but we think that in incorporating that fully into the public system improves our capacity we're going to do everything we can to get people the surgery they need when they need it that's what we've been doing but you know when you include the amount we pay to bring and to buy private MRI and bring it into the public system as a private cost in other words that's making the system more public but to suggest because we pay money for those things that it makes it more private it's just well it's not not the case of course and to suggest that the money for example that we might pay a radiologist through fee for service and then through health authorities of course we're paying more radiologists when you do go from 174,000 to 296,000 MRI exams you're paying more radiologists so all that's good news providing better service and that's that's what we're going to continue to do but indisputably I mean it's just beyond dispute the system become more public in the last four years that's true now the number is used in the reporter 2015 to 2021 I think and so that provides some conflation of that but the system's become more public I mean 296,000 MRI exams from 174,000 all without any MRI contracts in the private system that's making the system more public purchasing MRI machines that's making the system more public repatriating contracts in the hospital sector that's making the system more public all of these steps are the steps that organizations such as the CCPA have been asking us to do and what we've been doing so I find it that there are still surgical contracts with private providers providing care to patients for free or not for additional costs in the system following the Medicare Protection Act well that's not a bad thing for patients that's a good thing for patients but that number is smaller and we'll continue to get smaller why because we just purchased a couple of the biggest bigger private clinics Graham did you have a follow-up? Thanks for that response with regard to the Falls Creek extra billing I just want to get a better understanding of how you regulate and penalize these these companies so the overall question is that a stiffing up penalty for you to cancel the contract and then it's sold and they come you say it comes back into compliance and then they get more contracts after that are you could it be that are you in between a rock and a hard flight where you need these clinics to alleviate the waitlist and you can't blacklist them entirely for for having broken the law before or do you think that it's suffice that they can simply break the law come into compliance and then just get new contracts well first of all with respect to it's the obligation of everyone to follow the law and the Medicare Protection Act gets enforced in BC and will be enforced in BC and that's pretty straightforward but you know I want to say first of all the key is providing service to patients why did we dramatically increase the number of MRIs because people were waiting too long that effectively what the liberal party was doing in BC was telling people you have to go private and then come back in the public system advance in the waitlist if you had the money to do that and that was the largest share if you will of of what you might call a queue jumping that was taking place so how do you deal with that you don't deal with that simply by taking legal action against people you deal with that by increasing the capacity of the public system and we've done that on MRIs and CT and colonoscopies in an unprecedented way and that's good news for patients and that's what we've been about and the success is breathtaking compared to other jurisdictions in the country everywhere else so that's the first thing what happened with false creek surgical center well we did more than take action we canceled the contract and then the business was sold and then they came back and said we're gonna we can provide a certain number of surgeries in compliance with the Medicare Protection Act and they signed the contract saying they'd be in compliance with the Medicare Protection Act and there was a contract in place with it with a different owner of false creek surgical center I don't think the people who received that surgery which is a small share of surgery in the system 0.23 percent of health authority acute care expenditures 0.23 percent right don't think that's a good thing they went in they were booked for surgery there they didn't they didn't pay for that surgery they got the care they needed and that was important but overwhelmingly how have we done it we've increased operating room times under on the existing healthcare system we've activated mothballed operating rooms we increased hours we did surgeries on the weekend that's how we did it and it wasn't me that did it it was the surgeons and nurses and everyone else and so what happened with false creek was they weren't following the law they got the contract cancelled they eventually decided under new owners they were going to follow the law and the contract was restored and so that's that's pretty straightforward in the case of the ones on Vancouver Island they felt and we felt there was a real opportunity increased surgeries if the those clinics were purchased in the public system so we did that and we're going to do more surgeries there than ever before it's often going to be the same surgeons that do them but it's going to provide better access to care for people on Vancouver Island I think that's all good news but the direction is all one way it's the most efficient way which is an efficient successful operating public system you know you look at what we do in primary care the primary care system is an insurance system so many of the doctors in question their practice is is a corporation right but it's but the patients aren't paying for care there it's an insurance system they're supportive for care and that's part of the system that we have in Canada but and have done from the beginning of of the Medicare system in Canada but in short what we've done is taken very strong action to support the public system to enhance public surgeries to enhance public diagnostics and imaging and all of the evidence is one way and the only way not to say that is of course to admit the evidence our next question is for more what the tie please go ahead hi good afternoon thank you for taking my question um minister can you go into a bit more detail about the eligibility for this funding um how much of it is new and what's the allocation based on that attached patients typical number of days in the week in the clinic just a little bit more on that please it's people who are either through Auckland clinics or through longitudinal family practice providing care and I gave you the numbers earlier on that so that's 70% of family physicians in BC so it's um that eligibility is per doctor it'll be paid through the clinics and it's going to be paid in October Moira did you have a follow-up I do thank you um have the medical services commission completed its review of telehealth my care and where will that report be made public well um as you know and there's the medical service commission and uh Dr DeSage is on the commission so I won't ask her to speak can answer this question she's on the commission and as are many uh other outstanding British Columbians is their job to in to assess and enforce the law and so they do this in different ways there was a case a number of weeks ago of a clinic in the capital regional district that was proposing to charge a fee and they would draw on that now and the commission engaged with them in that case it wasn't an investigation they engaged with them and that was the conclusion right in the case of tell us health what the commission does so what happened tell us health issues around tell us health brought to my attention I asked the ministry of health the commission to review it and they're doing that and they don't just review it though so the process of review isn't them doing the review and sending me a report of me taking action the process is them doing the review and then taking action they're an independent body and they will announce their decisions not just their review but their decisions in due course and it won't be me announcing that it will be the commission we have time for one more question our final question today is for Ethan Sawyer cbc please go ahead hey minister thanks for seeking my question as you said $118 million is a significant amount of money I'm just wondering if you can clarify where these funds are coming from and also if you can clarify a little around the 30% of doctors who aren't receiving funds why not make this money available to everyone well because some doctors as as you'll note and if you've been following the issue you know some doctors are paid direct salaries and aren't paying overhead so this is one of the doctors we're talking about as doctors who are affected by that so effectively what this does in this period is it it makes a sort of the situation fairer so that a doctor say who's working as a hospitalist in a hospital and is getting paid perhaps the same amount as the physician in the community that is not paying overhead that doctor even though they're a family doctor in bc and providing family services and we love them and we think they're doing great they're not paying overhead right now they're getting their full salary and they'll continue to do that and they'll be subject to the negotiations we have with the doctors of bc across the categories so that that's the case this is these are the practicing physicians in the community who are affected by these these challenges of overhead and these challenges of costs that i and Dr. DeSanche have referred to and they're the ones who need this and they're the ones who will be getting the money so that's the that's the difference between the two Ethan did you have a follow-up oh yeah and i apologize um it's been a minute since i called into one of these is there any chance i can get that answer in french before i ask my follow-up uh well i'll try it in french when you add for the follow-up so i'll say i'll save it for those people who love my long answers in french at the end of press conferences and use it as an opportunity to go off the air and go to commercial i'll let them do that so i'll do all the french at the end how's that that's uh okay that's a note to note to networks no note to station so ask your follow-up and then i'll uh i'll try and give it a shot in french question is also about uh today's report about the so-called corporatization of healthcare just wondering if you can clarify uh particularly around default creek clinic uh when they fell out of compliance were they still able to do business and if so what does it say that these private companies are able to continue seeing patients uh even if they aren't necessarily compliant with the medicare protection act and if i can get that answer in french as well well um first of all um a doctor uh doesn't have to be in the medicare service plan to practice in bc that's regulated by the college so there's a usually a very small number of doctors forget the number is a very small number who can practice and they do and they do entirely private services for example there are a significant number of doctors who perform exclusively cosmetic surgery right they're not applicants in the plan and when you look at private medical care and the problems a lot of what we call private clinics are actually providing that that service which is um uh which you know is what it is um and so uh so i don't know so there that's the case so if you're not in the medical services plan or you're not getting a contract from the doctor from uh the government there are other sources um of services icbc has its own set of plans works a bc has his own set of plans assure all public systems and working for them is entirely compliant uh under the Canada health act for example so there's different different alternatives there but in this case the action couldn't have been clearer and it was you know um just for research purposes uh on i think the front page of the Vancouver Sun i may i may be wrong about that we took action to deal with Falls Creek and essentially move on from their contract um because um they weren't in compliance and when they came back into compliance uh we uh provided uh we agreed to provide them with a new contract it's pretty pretty straightforward that a small number of providers uh four percent it will be significant it would be significantly less this year uh of surgeries are contracted they're all within the public health care system this the the patients don't pay for them they're integrated into our weightless systems and people get the care uh the care that they uh they need it's of course in all of those cases they're all what we call day surgeries frequently uh cataract surgeries or other surgeries right so that's the kind of surgeries we're talking about so um you know uh we uh took the action so what did we do we dramatically increased the public system we delivered a massive increase in surgeries and an MRIs we took 84 uh measures to increase public uh public uh uh capacity in our surgical system and we reduced in a pandemic the number of people on our weight list um that's using the public system to deliver public services to people in addition we brought in measures amendments uh to the regulations around the Medicare Protection Act that had long been left dormant in 2018 and uh we took action in these cases and these contracts to make sure that all of those who do contracting work with us are in compliance with the Medicare Protection Act and so those are strong measures and Falls Creek is an example of that they were out of compliance their contract got canceled and you see that actually reflected I think in the numbers in the report and I think in French Minister is the situation for uh les vans qui ont besoin d'aide des soins des medecins des infirmières et d'autres pour soutenir notre système de santé première en colombie britannique c'est un travail en appris et on continue de le faire le système de transformation de la rémunération des medecins dans la relance uh on continue avec les on direct pour pour pour agir sur la situation actuelle en ce moment et pour aider des gens en ce moment pour protéger des services dans la province dans la province c'est 118 millions dollars pour chaque médecin ça va être un peu près 25 mille dollars pour dire pour faire avec les coûts qui augmentent pour des gens qui pratiquent leur leur profession de la mété dans la communauté et je pense que c'est une bonne action mais c'est seulement une première action on va en prendre d'offre c'était 84 dans notre réforme des des systèmes de chirurgie dans la province je pense que ça va être entre 1 et 84 pour notre système de soins de santé première dans la province et mais je pense c'est un commencement et cela reflète notre partenariat avec les doctors of bc merci beaucoup thank you