Evidence of meeting #36 for Human Resources, Skills and Social Development and the Status of Persons with Disabilities in the 41st Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was care.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

  • Danielle Fréchette  Director, Health Policy and External Relations, Royal College of Physicians and Surgeons of Canada
  • Robert Sutherland  President, Canadian Dental Association
  • Euan Swan  Manager, Dental Programs, Canadian Dental Association
  • Pat Vanderkooy  Manager, Public Affairs, Dietitians of Canada
  • Noura Hassan  President, Canadian Federation of Medical Students
  • Chloé Ward  Vice-President, Advocacy, Canadian Federation of Medical Students
  • Christine Nielsen  Executive Director, Canadian Society for Medical Laboratory Science
  • Marlene Wyatt  Director, Professional Affairs, Dietitians of Canada

3:45 p.m.

Conservative

Kellie Leitch Simcoe—Grey, ON

Thank you very much to all of you for being here today. We greatly appreciate it.

I am a fellow with the Royal College of Physicians and Surgeons, so thank you, Ms. Fréchette, for coming.

There's one thing I want to say before I ask you my question, just so we're clear on the record with regard to jurisdictional issues with respect to physicians. Let's be very clear: the provinces create the spots for residents, whether those are Canadian-trained or physicians from overseas. We as a federal government have no capability to intervene in that. It's a completely provincial jurisdiction.

I'd like to ask a question of all of you, really, to get a sense from your standpoint of the skill shortages we're looking at for the health sector overall. I recognize that, as stated, I don't have any problems getting access to a dentist, but maybe you foresee challenges in the future. Maybe you could address some of those areas you've spoken of, whether it be children, aboriginals, or individuals who are low income, with respect to this question.

What do you see as the top three barriers to making sure we have an adequate supply, whether it be physicians, dentists, or the technical people who your health professionals deal with on a daily and regular basis in order to do their jobs? I know I need a dental hygienist every time I go to a dentist's office. There is significant support staff for health care professionals.

What are those key barriers that you foresee would contribute to those shortages or to the lack of health care professionals being available to Canadians?

3:50 p.m.

Director, Health Policy and External Relations, Royal College of Physicians and Surgeons of Canada

Danielle Fréchette

If you're thinking of redressing maldistribution in our rural communities and recognizing work-life balance as being key, I think a creative use of electronic care, where you could bridge a local clinician with a series of clinicians in some of the larger urban communities, so that they're not the lone practitioner there....

When you're recruiting someone to a rural community, you're not just recruiting the clinician; you're recruiting the family. Recognizing that it does take a while to produce a fellow of the Royal College or the College of Family Physicians of Canada, you're looking at really attracting the whole family. So you're looking for employment for the spouse or their partner, and they want good schools for their children.

These are very locally specific issues that are really outside the realm of the federal government, but those are some of the real barriers.

3:50 p.m.

Conservative

Kellie Leitch Simcoe—Grey, ON

Dr. Sutherland.

3:50 p.m.

President, Canadian Dental Association

Dr. Robert Sutherland

There are three things, I would say. One would be the cost to train and the cost to run a practice. The cost to train is expensive and the cost to run a practice is expensive. We run kind of mini-hospitals, if you will, as a dentist. The same procedures are going on and the same sterilization. We have a well-trained and costly workforce. So I think that is one area of barriers.

I think a lack of maybe a common set of guidelines across the country in long-term care facilities would be a second, and a third would be a lack of general education around the need for oral health care. Listed as probably the number one reason why people don't attend a dentist is that they don't feel they have a problem.

3:50 p.m.

Conservative

Kellie Leitch Simcoe—Grey, ON

Okay. Very good.

I have a second question, and I'm focusing more on the educational component. We obviously have to create a pipeline for these individuals to be available. What are your recommendations for the federal government on what kind of role we can play in facilitating that type of pipeline?

I'm a product of your system. I know that my colleagues who were educated in northern Canada tended to go home to northern Canada.

Do you have recommendations or suggestions along the lines of what items would be within federal jurisdiction that we could be involved in? One thing we put forward is loan forgiveness, both for medical students as well as for nurse practitioners, so that individuals who are willing to go to remote and rural locations are encouraged to do so by having forgiveness of their Canada student loan.

Do you have suggestions on how we can encourage people to go to those other areas of the country through the educational pipeline so that they end up where we'd like them to be?

3:50 p.m.

Director, Health Policy and External Relations, Royal College of Physicians and Surgeons of Canada

Danielle Fréchette

We'd probably have the solution to world peace if we could answer that question.

Loan forgiveness may be a slight enabler, but it doesn't really inculcate in the future physician the desire to go work in those communities. We do know that exposure to these sites—and we look at the Northern Ontario School of Medicine as a real success story. It's being examined internationally as the way to train some of the doctors of the future.

We are the land of pilot studies, but there's nothing wrong with piloting some of these wonderful ideas, to have some outlets for either faculties of medicine or institutions such as the Royal College to really try to look at new and exciting ways.

We do have, now, a new pipeline for pilots. Any faculty of medicine that wants to pilot a new program, a different way of training doctors, can, but they're doing it on the backs of their own institutional budgets.

You mentioned that education in health care is purely provincial, but what we're missing is this cohesive picture. I know I sound like a broken record, but a health workforce is a science, and we have to get those connecting pieces together. We have so many success stories throughout the country. I just quoted the Northern Ontario School of Medicine as one, but we have other pockets of excellence.

In our institution, we accredit over 700 training programs in the country in our 67 disciplines. We see wonderful things, but there is no outlet where we can put in this wonderful repository these great success stories that might inspire others as well.

3:55 p.m.

Conservative

The Chair Ed Komarnicki

Thank you for that, and your time is up.

Mr. Sutherland, did you want to make a comment?

Go ahead.

3:55 p.m.

President, Canadian Dental Association

Dr. Robert Sutherland

On the issue of loan forgiveness, we could consider on the provincial end piloting something like tying a financial incentive to having people contract to work in remote areas for certain periods of time, to see if that might be a help. Dr. Swan might be able to speak to the issue that across the faculties of dentistry in Canada, about eight have set aside specific seats within the dental program for special consideration. Those would be the type of people....

Hopefully, they would be aboriginals, they would be people from remote areas who would be given some other consideration, and there would be an incentive to go back to where they were.

I mentioned the Ontario Dental Association's remote areas program. That's where the federal government has contracted the delivery of services for an area in northwestern Ontario that's literally the size of France. The Ontario Dental Association currently has the contract to supply dentists to that area.

That sort of thing might be something to consider as well.

3:55 p.m.

Conservative

The Chair Ed Komarnicki

Mr. Swan, did you wish to add to that?

May 7th, 2012 / 3:55 p.m.

Dr. Euan Swan Manager, Dental Programs, Canadian Dental Association

Only to confirm, Mr. Chair, as Dr. Sutherland has mentioned, that seven of the ten dental faculties in Canada have places set aside for aboriginal students, to encourage the recruitment of aboriginal students from first nations, who would then return to the communities, as Dr. Sutherland said, and have the cultural competency to provide care to the local folks there.

3:55 p.m.

Conservative

The Chair Ed Komarnicki

Thank you.

Mr. Lapointe, go ahead.

3:55 p.m.

NDP

François Lapointe Montmagny—L'Islet—Kamouraska—Rivière-du-Loup, QC

Thank you, Mr. Chair.

Ms. Fréchette, I would like to digress for a moment before I address what seems to be the main issue.

3:55 p.m.

Conservative

The Chair Ed Komarnicki

Are you okay with the translation?

3:55 p.m.

President, Canadian Dental Association

3:55 p.m.

NDP

François Lapointe Montmagny—L'Islet—Kamouraska—Rivière-du-Loup, QC

Ms. Fréchette, your assessment of the situation regarding foreign-trained specialist physicians seems to be rather pessimistic. You said that the situation in francophone countries was rather disappointing.

Does that include people who were trained in Europe, such as French physicians who have to start their education process practically all over again?