Health Committee on Nov. 22nd, 2007

[Lui Temelkovski, Liberal, Oak Ridges—Markham, ON]

Okay.

Maybe you'd know how many doctors we are short of in Canada.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

Well, we have a shortage of all medical professionals, you're quite right. In all seriousness, this is a world-wide shortage. The world-wide shortage today of medical professionals is in the order of five million and is likely to grow.

[Lui Temelkovski, Liberal, Oak Ridges—Markham, ON]

What's Canada's share of that?

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

I can't calculate that off the top of my head, but we will get you a number.

But you are right that there is a world-wide shortage and a Canadian shortage of medical professionals. That is why we're working with the provinces and territories pursuant to the 2004 health accord. There is a $100 million pot that will help us deal with credentialling issues and with pan-Canadian strategies for recruitment and retention, and we have to continue to work with the provinces on that.

[Lui Temelkovski, Liberal, Oak Ridges—Markham, ON]

Maybe you're aware of the number of foreign-trained doctors who are living in Canada who can help with this shortage. Do you have any numbers for those?

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

I don't want to do it off the top of my head, so I can get you a number on that. I remember from my Ontario days that the number in Ontario was close to 1,300 IMGs, international medical graduates.

That's an area, of course, that's of great concern to us. I believe the Minister of Immigration is working on our one-stop window to help with credentialling matters.

[Lui Temelkovski, Liberal, Oak Ridges—Markham, ON]

Obviously, we would need some residency spots for these foreign-trained doctors. Maybe you have a plan for that, for increasing the current residency spots in Canada. By how many?

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

Yes, as I have been trying to explain, we have a particular pot, I believe, of $75 million over five years that was part of the health accord, specifically designed to expand the assessment and the integration of international medical graduates.

Certainly that is our continuing commitment, and I'm hopeful it will have an impact.

[Lui Temelkovski, Liberal, Oak Ridges—Markham, ON]

So, basically, we don't know how many more residency spots we will need to fill the shortage of doctors Canadians need today?

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

I think it's fair to say that it's going to be a combination of things that will help with this. First of all, the number of medical school places in recent years has increased by 30% in this country, after a disastrous turn of events in the early 1990s, when governments of all stripes reduced the number of medical school spaces. So that will, in the long term, obviously be of assistance.

You have the international medical graduates, and you have perhaps a lot of provinces looking at other means of delivering medical services, looking at scopes of practice issues, like physicians' assistants and nurse practitioners, which will help ease the situation in some areas. And integrated health teams will be important, which a number of provinces are pursuing, partially with funding from the federal government.

So I don't think there's one magic bullet in this, but I believe that a combination of things will be of assistance to you.

Our goal, incidentally, is to get 1,000 doctors, 800 nurses, and 500 other medical professionals as a result of our funding.

[The Chair, Conservative, Joy Smith]

Thank you, Mr. Temelkovski. I'm sorry, but I've let you go over your time here, so I'd better cut this off.

Mrs. Davidson.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Thank you, Madam Chair, and thank you, Mr. Minister, for appearing before our committee today, and also to the members of the different departments as well. We certainly appreciate your being here to answer our questions.

I want to take my questioning on perhaps a different route than we've been this morning and talk a little bit about pest management control, and maybe ask some questions on that.

I think we all know that the environment and health have definitely been linked far more closely over the past year or so, and that this avenue is probably going to be continuing. I see in the estimates that you're seeking just over $3 million in additional funding for pest management control, so I'm wondering if you could maybe speak to that a little bit and tell us what that $3.4 million would be going towards and what you're maybe doing to allow newer, safer pest control products on the market. I think that's definitely been the thrust from communities, and local levels of government as well.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

Thank you, and as the honourable member is probably quite aware, there have been significant technological advances and research into pest management, which requires that Health Canada assess, through the PMRA, these new chemical compounds and new pesticide management initiatives.

I believe a lot of that money will help us address the technological gap, making sure we can increase our evaluations so that they become quicker and therefore those products that are safe for use can get into our marketplace sooner than has hitherto been the case.

We're also re-evaluating existing reduced risk pesticides, and we're using refined risk assessment criteria, which will maybe expand the universe of growers these pesticides might be used by.

So that's where the money is going.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

Thank you.

I just wanted to go back to a remark you made on page 4 of your comments, where you said that as a result of cuts to spending made in the previous government's budgets of 2004-05 and 2005-06, you're legally required to identify $16 million in savings at the Public Health Agency of Canada.

I know this question or issue has been alluded to already, but I'm not sure you had the opportunity to respond fully, so I'd like to ask that you do that now, please.

[Tony Clement, Conservative, Parry Sound—Muskoka, ON]

Sure.

I have certain legal obligations, and one of my legal obligations is to not offend Parliament. If Parliament has passed budgets in previous years with, in some cases, long hang times, I do have to implement those.

Some other honourable members commented that there were ways to ensure that the $16 million in cuts to the Public Health Agency had not taken effect in 2005, 2006, and 2007. That's true. But eventually the clock does tick and eventually we have to live up to the parliamentary requirements.

That's what I'm doing. I'm trying to do so in a way that is least disruptive for Public Health Agency programming in every area, including HIV/AIDS. I identified, I thought, through this plan...and the Public Health Agency identified this $7 million Canada Health Network website, where we could go from three websites down to two websites and accomplish the same mission but save $7 million.

I agree that I was obliged to make that choice, but I actually agree with that choice. I'm willing to defend that choice. I think that's the right choice to make, so that other programs can continue on.

We're continuing with that exercise. There will be more reductions that will be coming. I'm not trying to hide anything. But that is the reasoning behind it. My commitment is, whether it be the HIV/AIDS programs or other programs within the Public Health Agency, that we don't want to get to core initiatives, we want to ensure that all the good work being done in the community continues to be done. But I have this obligation to Parliament, which I am going to fulfill.

[The Chair, Conservative, Joy Smith]

We only have about 20 more seconds, if you have a comment, Mrs. Davidson.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

I've finished, thank you.

[The Chair, Conservative, Joy Smith]

Thank you so very much.

Everyone has had a chance to ask a question. What the procedure is, following Ms. Gagnon's question, is to go into a conclusion. We will give you time, Mr. Minister, for a conclusion.

We have exhausted the list of questioners.

Ms. Gagnon.

[Carolyn Bennett, Liberal, St. Paul's, ON]

Excuse me, Madam Chair, the committee determines its work.

[Christiane Gagnon, Bloc, Québec, QC]

I would like to come back to an issue we have discussed before, Minister.

[The Chair, Conservative, Joy Smith]

Madam Gagnon, excuse me, we have to go. I'm so sorry, we're running out of time. We have to give the minister time for conclusions and then we have to take some votes.

[Christiane Gagnon, Bloc, Québec, QC]

You say we have 20 minutes to wind up? We have never worked that way.

[The Chair, Conservative, Joy Smith]

No, no. If you will let me finish, I will make this proposal to you. We can wait for a few minutes until we all get organized.

What I'd like to do is this: we need time for voting--

[Christiane Gagnon, Bloc, Québec, QC]

No, it's my turn. We have two questions for the Bloc--

[The Chair, Conservative, Joy Smith]

Excuse me! This is what we need to do: we need time—