Bill S-248 (Historical)

National Physicians’ Day

An Act respecting National Physicians’ Day

This enactment designates May 1 as “National Physicians’ Day”.

National Physicians' Day Act

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Mr. Speaker, I am pleased to rise in the House to speak to Bill S-248, an act respecting national physicians’ day.

This bill designates May 1 as national physicians' day. It seeks to recognize the importance of the 125,000 resident and student physicians across the country.

In coming to my decision to support this bill, I considered the following points.

Members who have been here for four years have seen a number of days, weeks and months of various sorts to recognize great things across the country, but what could be more important to recognize than our doctors? Doctors save our lives. Every one of us is going to need a doctor at some point in our life, and usually all the way throughout, from the time we are born to the time we go into palliative care and pass on from this life. It is definitely worthy to have a day to talk about doctors and all the things they do.

From the time people decide to go into medicine, it is an incredibly long journey. We know it is difficult to get into med schools, and once they are there, they study for extremely long hours. It is a very competitive field. Once they have finished their studies, they have to do their residency. This involves extremely long hours of work, very interesting work, when they get real experiences. My nephew is a doctor. He did undergraduate work in Michigan, but got his medical training in St. Martin, which sounds like a wonderful place to get medical training. He did his residency in the U.S., so he had the opportunity to work in Detroit and Long Island. One can imagine the excellent training he got in the emergency departments there. He and so many other doctors go through all of that, and at the end of their studies and just beginning their careers, many of them have racked up between $200,000 and $300,000 worth of debt in student loans.

It is really quite a commitment to embark on becoming a doctor in the first place, and one of the problems in Canada is graduating enough doctors. There is a certain number of spots for residents. When I became the shadow minister of health, I became aware that there was an issue with the matching of residents to positions and, in fact, some of them were unable to get a position. We can imagine, after all the training doctors have gone through, how devastating that would be not to be able to pursue their life's dream. I was able to work with the health minister to address that gap.

That being said, there is a huge doctor shortage right across the country. I have been able to go from coast to coast to coast to see the state of the nation in terms of doctor shortages, and I can say there are some very dire situations. Cape Breton is missing 52 emergency room physicians and a vascular surgeon. Individuals who cut an artery there would lose a limb or die because they cannot get to Halifax in time. In Ottawa, the wait time for a family physician is six years. In B.C., there is a huge shortage of doctors. There is an incentive system there that has resulted in having more emergency room doctors than family doctors. Rural and remote spots across the country are in dire need of doctors.

I have a list of the types of doctors missing in my own riding of Sarnia—Lambton. We are missing 10 family doctors, two geriatricians, one rheumatologist, three psychiatrists, one rural emergency physician and two other ER physicians, one plastic surgeon, two anaesthetists and an otolaryngologist, though I am not sure what that is.

The government should definitely be taking a leadership role. We recognize that, while health care is executed by the provinces, the federal government has a responsibility to address this gap. We have an aging population. One in six seniors right now will become one in four seniors in six to 10 years, so we are going to need even more doctors. We are short 600 palliative care physicians and innumerable doctors for seniors.

It is time to work alongside the provinces and territories to figure out how to address what is really a disastrous shortage. Without a doctor, how is someone going to stay healthy or deal with chronic disease?

It is worthwhile having a day to celebrate doctors, but it is a bit hypocritical for the Liberal government to be bringing this forward. It was a Senate bill originally brought forward by Senator Eggleton, but the Liberals have brought it forward. As a government, Liberals have not been kind to doctors. Remember, it was the Liberal government, under the finance minister, that called doctors tax cheats. It did not recognize that when doctors have their corporations and run their medical practices, they need to accumulate passive income to buy the equipment they need to run their practices. The government wants to tax them at a 73% rate. Again, the Liberals have not treated doctors well.

If we look at the medical assistance in dying legislation that was brought forward, it was the Liberal government that did not protect the rights of conscience of doctors in this country, even though it was brought to its attention. Most recently, the Ontario court has not allowed for doctors to have freedom of conscience with respect to assisted suicide in Ontario. That has never happened anywhere else in the country, in the world, and it was the Liberal government that began that path.

When doctors are becoming doctors, it is a very long and arduous process. However, once they become doctors, they face very strenuous working conditions with very long hours. They may be working 80-hour weeks, depending on whether they have someone helping them out in their practice. As well, the Standing Committee on Health is doing a study right now about the violence that health care workers experience. I was astounded to learn that more than 60% of health care workers, including doctors, are experiencing violence from patients, frustrated family members and people who suffer from mental health and addiction issues or dementia. There is a real and serious problem that we need to address on behalf of doctors.

Many people know that I am a passionate advocate for palliative care. While we are talking about having a national doctors' day, I send thanks to the doctors at the palliative care at St. Joseph's Hospice in Sarnia—Lambton. I thank them for everything they do. I also thank the palliative care physicians across the country and those who work in that area. With the aging population we have, we need to do more to make sure that Canadians can choose to live as well as they can and for as long as they can. There are 70% of Canadians who do not have access to palliative care today.

The palliative care framework brought in under my bill, Bill C-277, has certainly helped to advance the cause. I have worked with the health minister and the parliamentary secretary, who I see is here today, to try to make sure we have training for health care workers in palliative care and the infrastructure we need in terms of hospices and broadband Internet to access virtual palliative care. As well, we need to take the innovative ideas put in place across the country, with the paramedics, for example, learning palliative care and taking that to rural and remote places, and that we take all of those ideas and make sure we build our palliative care capacity in the country.

In summary, there is more to be done. There is more to be done to support doctors, and not just their rights of conscience or the tax laws that allow them to operate here. We have to also listen to the doctors when they provide advice. The Canadian Medical Association provided a lot of input on the cannabis regulation, and it was largely ignored. While having a day for doctors to celebrate is great, there is a lot more that we could and should do to celebrate how important doctors are to each one of us. They save our lives and help us throughout our lives. I am certainly happy to stand here today with Bill S-248 and say that I will support this bill. Happy national doctors' day.

[Jenny Kwan, NDP, Vancouver East, BC]

Mr. Speaker, it is with great pleasure that I rise in this House today to speak in support of Bill S-248, an act respecting national physicians’ day. This bill would designate May 1 as national physicians' day across Canada.

I appreciate and find it fitting that May 1 is also the birthday of the first woman selected to practise medicine in Canada, Dr. Emily Stowe.

As the member of Parliament for Vancouver East and someone who has been an elected representative at all three levels of government in Vancouver, I know just how important is the work and leadership of doctors in my riding, across Vancouver, throughout British Columbia and across the country.

Let me address an urgent health issue that is gripping communities across the country. As we know, Canada is dealing with a national opioid crisis, and the Downtown Eastside of Vancouver is the epicentre. While the government has been slow to act on this crisis and continues to refuse to declare a national health emergency, doctors in B.C. have been showing leadership on this issue for years.

Dr. Bonnie Henry was appointed B.C.'s provincial health officer in 2018. She is B.C.'s first female provincial medical health officer. Last month, Dr. Henry spoke to the CBC to reflect on it being three years since the previous provincial health officer, Dr. Perry Kendall, declared a public health emergency in response to the opioid-related overdose deaths in British Columbia. When asked about policy changes that have helped, she cited great strides in changing naloxone from a prescription-only drug to something available over the counter to it now being available and free everywhere. She also stated:

one of the other really important things is we've been able to change the public discourse about people who use drugs and about addictions. People understand that these [people] are our community. It's not just "those others."

Dr. Henry, in an earlier statement, also called for more and bolder actions to continue improving the situation and taking concrete steps to end this national health emergency. She stated:

We need options to provide people at risk of overdose with low-barrier access to a regulated supply of opioids, and we need to connect people who use drugs with the supports they need rather than sending them to the criminal...system.

In fact, she went on to call for the decriminalization of all drugs. She made it clear that a safe supply and the treatment of addictions is a health issue, not a criminal issue. Her work is a continuation of that of her predecessor, Dr. Perry Kendall.

Dr. Kendall recently retired as a long-time advocate for harm reduction. He has been one of B.C.'s most outspoken voices on the ongoing opioid overdose crisis. He led the way in our country and declared the situation a public health emergency in 2016 in B.C. Dr. Perry Kendall was there when the first supervised injection site in North America opened in Vancouver. Since that day, he has continued to ensure the discussion about the safe site is evidence-based. Dr. Perry Kendall is not alone in this effort.

Dr. Mark Tyndall, formerly with the BC Centre for Disease Control, has been a vocal advocate for addressing the opioid crisis. He was the lead of research and evaluation for the PHSA Opioid Overdose Response Team and was co-lead investigator on the evaluation of Insite, North America's first supervised injection facility. While he has recently left the organization, he continues to be a leading voice on this important issue.

Then there is Dr. Julio Montaner. He was the leading physician on the North American opiate medication initiative, known as NAOMI, and the study to assess longer-term opioid medication effectiveness, SALOME. These clinical trials were instrumental in saving lives, and his research was pivotal in the 2011 Supreme Court decision against the Harper Conservative government to shut down Insite.

There is also Dr. Patricia Daly, the chief medical officer at Vancouver Coastal Health. Like those mentioned, she and her predecessors at VCH have been showing true leadership on this crisis. In January of this year, she issued an update on the overdose crisis. This update concluded with four recommendations moving forward: establish a system of care for people with addictions to implement treatment standards and monitor outcomes; expand access and remove barriers to opioid agonist therapy; establish a safe, regulated supply of drugs; and expand programs that can prevent addiction, which focus on vulnerable youth, indigenous peoples and people living with physical pain.

It is clear there remains much work to be done in Vancouver, throughout British Columbia and across Canada to truly end the opioid crisis we are facing.

From January 2016 to September 2018, there were more than 10,300 lives lost in opioid-related deaths in Canada. Ninety-three per cent of these deaths were considered accidental or unintentional. From January to September 2018, there were 3,286 deaths with 1,155 of them occurring in B.C. Seventy-one per cent of those deaths were attributed to fentanyl.

Thanks to the doctors I have mentioned and the many others I do not have time to name, we have started to see a reduction in deaths. We also know that without their work, advocacy and leadership, our communities would have lost thousands more of our loved ones.

We as elected officials must take their advice seriously. We must act. Lives are at stake. The work of these doctors and countless others has helped provide other front-line service providers with the tools and information to help reduce the devastation of this crisis.

While this bill is about recognizing National Physicians' Day, I feel that given the work that physicians do and its far-reaching impacts, it is also important to recognize who their work supports and who supports their work. That is the front-line doctors, nurses, first responders and community service providers such as Sarah Blyth at the OPS, working tirelessly day in and day out to save lives.

Backing up the work of physicians are public health policy-makers. I would like to highlight the work of Dr. Steve Morgan, director of the UBC Centre for Health Services and Policy Research. Dr. Morgan and his team at Pharmacare 2020, including Dr. Danielle Martin, MD; Dr. Marc-Andre Gagnon; Dr. Barbara Mintzes; Dr. Jamie Daw; and Dr. Joel Lexchin, MD, have shown us clearly that the best path forward for Canadians is a public universal pharmacare plan. Their research leaves no doubt. They state:

Evidence from across Canada and around the world shows that Pharmacare is the best system for achieving:

universal access to necessary medicines

fair distribution of prescription drug costs

safe and appropriate prescribing, and

maximum health benefits per dollar spent.

This report explains why this is the case and therefore why Canadians deserve Pharmacare by 2020.

Even under conservative estimates by the Parliamentary Budget Office, had a program like this been in place in 2015, Canadians would have seen savings of over $4 billion. Physicians across Canada know all too well about the barriers high prescription drug costs have on their patients.

According to a 2018 Canadian Medical Association survey, 46% of physicians said patients without drug coverage were not filling their prescriptions.

I have heard far too many heartbreaking stories. It is time for the government to act. I believe that we must match our words with actions. That means recognizing the strain we put on doctors by failing to eliminate the barriers that patients have in accessing the treatment regimes they prescribe. That means investing in harm reduction. That means a universal pharmacare program.

We can all do this. We should recognize and thank doctors for their work, but equally important, let us make policies and take action to realize what the doctors hope to achieve for all Canadians.

[Pam Damoff, Liberal, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, it gives me great pleasure to be here today to speak to Bill S-248, an act respecting national physicians’ day.

The hon. Art Eggleton introduced this bill in the other place prior to his retirement. I would like to thank him, as well as the member for Vancouver Centre, who is herself a physician and the bill's sponsor in the House, for bringing this forward.

Bill S-248 seeks to designate May 1 of each and every year national physicians’ day. During debate in the Senate, Senator Eggleton indicated that this date is significant for physicians, because it is the birthday of Emily Stowe, the first woman to practice medicine in Canada and a leading suffragette in her time. How appropriate that the bill is being sponsored in the House by the member for Vancouver Centre, the longest serving female member of the House and a trailblazer both as a physician and an elected official. There are few people in this country who have done as much for those living with HIV/AIDS than this member, who is now focusing her efforts on the opioid crisis. Canada is a better place for her service, both as a physician advocate and a member of Parliament.

Should this bill receive royal assent, the federal government would replicate nationally the actions of Ontario and Nova Scotia, which at the provincial level already designate a Doctors' Day at the beginning of May. In designating such a day, Canada would join a number of other countries, including the United States and India, which already set aside similar days for the recognition of physicians.

The bill's intent is to acknowledge the contributions of physicians to the health of Canadians and to increase public awareness of the role they play in providing high-quality care. As is well known, it is a point of pride among Canadians that we live in a country fortunate enough to have a world-class medical system. Clearly, physicians are integral to the viability of this system.

In 2017, there were over 86,000 physicians in Canada, representing 234 physicians per 100,000 people. It is interesting to note that in recent years, the profession has become increasingly female and multicultural. Women now account for 41% of physicians in Canada, while those who acquired their medical degrees elsewhere constitute 26.5% of all physicians in this country.

I recently met with a group of medical students, led by Stephanie Smith, a former army nurse who twice served in Afghanistan and just days ago graduated as a doctor from medical school. Stephanie and her colleagues are the future of medicine, and these future physicians give me great hope.

Everyone in this chamber has at one point or another been touched by the compassion and the professionalism of a physician. Just last month, when I fainted in this House, we saw three physicians jump into action to attend to me. Speaking today to this bill gives me the opportunity to publicly thank the members for Toronto—St. Paul's, Charleswood—St. James—Assiniboia—Headingley and Markham—Stouffville for their prompt attention, care and concern.

Physicians, going back to Hippocrates and the foundations of the modern medical profession in ancient Greece, are guided by a set of ethics whose central tenets are to do no harm, to show respect for the patient in all situations and to always help when help is needed.

Physicians affect every stage of life. They are central figures at times of birth and death. They are the specialists we seek out during periods of crisis, and they are the family doctors we rely on to manage day-to-day illness. They work collaboratively with other health professionals, such as nurses, both in and out of the hospital setting, to advance the well-being of their patients. They are often the researchers who are at the forefront of many innovations that are helping us live longer and healthier lives and that give us hope for the future.

I think of people like Dr. Duncan Rozario, head of surgery at Oakville Hospital, whose innovations in Oakville are leading the country in many areas, from changing the way opioids are prescribed to the mental health of the hospital's employees, all of which ensure better patient outcomes.

I have had the distinct pleasure of getting to know Dr. David Malkin, a Terry Fox-funded researcher at Sick Kids, in Toronto. Dr. Malkin's research is focused on genetic predisposition to cancer, specifically childhood cancer, and he is a world-leading expert on Li-Fraumeni syndrome. He has graciously hosted me at Sick Kids twice now, and I had the great privilege of joining him for rounds and clinic back in April. What a gift to be able to witness his team of physicians and health care providers attend to these young people and their families.

We must also be aware that the privileged place that physicians hold in our society also brings with it enormous responsibilities and pressures. This is why, in addition to celebrating physicians, the bill also aims to draw attention to the challenges they sometimes face by virtue of what we ask of them. While extremely fulfilling, a medical career can sometimes also entail immense psychological burdens. Physicians operate in an environment that emphasizes self-reliance and resiliency. They work long hours, are frequently on call, and bear an enormous amount of responsibility, often in extremely stressful situations.

As is the case for our first responders, physicians also frequently encounter emotionally draining and difficult situations that can lead to forms of psychological trauma, such as post-traumatic stress injuries.

Given these factors, it is perhaps not surprising that research on the profession has consistently shown that physicians are at a greater risk of suffering from mental health problems than many other professions. For instance, the Canadian Medical Association's “National Physician Health Survey” recently found that although most physicians self-reported their mental health as good, fully 34% reported symptoms of depression and 26% also reported feeling burned out.

Anecdotal evidence also suggests that physicians have a high suicide rate when compared to other occupations. The Canadian Medical Association's health survey also found that 9% of physicians had reported suicidal thoughts within the last 12 months.

The Standing Committee on Health just commenced a study on violence against health care professionals. We have heard from physicians about the violence that they can be subjected to, in particular in emergency rooms and hospitals. I have had the pleasure of getting to know Dr. Alan Drummond, an emergency room doctor and passionate advocate for saving lives by recognizing the impact of firearms on suicide and intimate partner violence. He is someone who sees every day the impact on physicians of the challenges they face in their workplace and the need to do more to support them.

Senator Mégie, who is herself a physician, said during debate on this bill in the other place, that a career spent in the service of others can make it very difficult to accept the need to ask for help for oneself.

A national physicians' day could perhaps, in a small way, provide an occasion to help and reverse this tendency by allowing Canadians to collectively celebrate and express their appreciation for the extraordinary dedication of these medical professionals. It could also serve as a means for a sort of role reversal, by permitting society to assume the role of the caregiver, signalling that we do not take the contributions of physicians for granted, are interested in their well-being and are in solidarity with the difficulties they face. Possibly through the avenue that a national day would provide, broader discussions could begin on these and other important issues.

The subject is of great interest to the Minister of Health, and the government is very pleased to support this motion. I want to reiterate my thanks to the member for Vancouver Centre for sponsoring this bill, and to the House for the opportunity to reflect on its importance as we move forward with reviewing it in greater detail.

I look forward to further discussion on what a national physicians' day would look like, and appreciate its overall aim to support and express gratitude to physicians in Canada. Finally, I would like to thank physicians across Canada for all that they do for us.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

Mr. Speaker, Canadians are proud of our publicly funded health care system. It is a central pillar of our national identity. To ensure all Canadians can access the care they need when they need it, our government is making unprecedented health care investments. We have invested a transformational $11 billion to support home care and mental health coverage for all Canadians at every stage of their lives. Our focus on home care and mental health wellness is in addition to the over $38 billion already invested through the Canada health transfer this year alone. These investments are evidence of our government's commitment to support, modernize and renew Canada's public health care system.

I would like to thank the hon. member for Vancouver Centre for sponsoring this bill honouring the important role of physicians in the health of Canadians. Bill S-248 proposes to designate May 1 as national physicians' day, a day to recognize and show appreciation for the positive impact physicians make on the health of Canadians and to celebrate the achievements of medical professionals.

The hon. member herself practised family medicine at Saint Paul's Hospital in Vancouver for several decades, and she is a leader within the medical community. I would like to acknowledge and thank her for her lifelong commitment to public service, both as a physician and as a dedicated parliamentarian.

It is long overdue that we have a national day to recognize the contributions physicians make to their patients and their communities. Physicians play an essential role in all stages of our lives. They help us maintain positive health outcomes, tend to us when we are ill, support us and our families through chronic and prolonged illnesses and advocate for better patient care. We rely on physicians to care for the health of our children, our partners, our parents and ourselves. Canadian physicians are among the top three most trusted professions.

While physicians enjoy high levels of public trust, they themselves are subject to mounting stress. Research confirms that because of the long hours, high pressure and traumatic experiences physicians face, they are at a greater risk of suffering from mental health issues. Their sacrifices for public health must be recognized and appreciated.

As a member of the Standing Committee on Health, I have had the opportunity to study many issues that intersect with the health care community. I have seen first-hand the resilience of our medical community. Time and time again, physicians are stepping up and stepping in to solve problems, proactively identify issues and develop innovative ways to practise medicine better.

We have just begun a study into the issue of violence against health care workers, and the testimony provided by physician witnesses has proven indispensable in determining how to reduce the regular violence that nurses, paramedics and other health care workers face every day.

Additionally, in an issue that is affecting families across the country and in my community of Coquitlam—Port Coquitlam, physicians are playing an essential role in addressing the root causes and severe consequences of the opioid overdose crisis. While direct support for physicians is limited by provincial and territorial jurisdiction, Health Canada funds a number of national-level programs through grants and contributions. These programs promote collaborative, pan-Canadian approaches.

Choosing Wisely Canada is one such example. This program is a physician-led campaign by the Canadian Medical Association to help physicians and patients engage in conversations about unnecessary tests, treatments and procedures. This is just one example of the many instances of leadership provided directly by physicians.

Physicians are leaders in patient care, research, health policy, education and innovation. They are key partners in our government's efforts to improve our health care system to reflect the needs of all Canadians.

This bill proposes May 1 as national physicians' day, a date that commemorates the birth of Dr. Stowe, the first woman to practise medicine in Canada. Denied entry to the Toronto School of Medicine, she obtained her degree in the U.S. before returning to Canada as a practising physician in 1871. Dr. Stowe became a lifelong defender of women's rights and a champion for women in medicine. Her medical clinic provided practical clinical experience to the members of the Women's Medical College and provided services regardless of a patient's ability to pay. Her story of selflessness and community activism underpins our Canadian medical community.

Of course, we do not have to go back to the 1800s to find inspiring stories of physician care. In my community of Coquitlam—Port Coquitlam, Dr. Elizabeth Payne received the “My Family Doctor” award from the BC College of Family Physicians. This award celebrates doctor-patient relationships that promote good health. Dr. Payne has served Coquitlam—Port Coquitlam for over 40 years, providing family care of the highest quality. I would like to thank Dr. Payne for her many years of service and continued work in Port Coquitlam.

There are countless physicians in communities across Canada who go above and beyond for their patients, and they all deserve to be recognized. I fully support this bill, sponsored by the hon. member for Vancouver Centre, to make May 1 a day to recognize, celebrate and appreciate the importance of physicians and the medical community.

[The Deputy Speaker, Bruce Stanton]

Is the House ready for the question?

[Some hon. members]

Question.

[The Deputy Speaker, Bruce Stanton]

The question is on the motion. Is it the pleasure of the House to adopt the motion?

[Some hon. members]

Agreed.

[The Deputy Speaker, Bruce Stanton]

I declare the motion carried. Accordingly, the bill stands referred to the Standing Committee on Health.

(Motion agreed to, bill read the second time and referred to a committee)

[The Deputy Speaker, Bruce Stanton]

It being 2:05 p.m. this House stands adjourned until Monday, May 27 at 11 a.m. pursuant to Standing Orders 28(2) and 24(1).

(The House adjourned at 2:05 p.m.)