Bill S-248 (Historical)

National Physicians’ Day

An Act respecting National Physicians’ Day

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

Health

[Bill Casey, Liberal, Cumberland—Colchester, NS]

Mr. Speaker, I have the honour to present, in both official languages, the 25th report of the Standing Committee on Health in relation to Bill S-248, an act respecting national physicians’ day.

Bill S-248 would designate May 1 as national physicians' day. I would like to thank retired Hon. Senator Arthur Eggleton and the hon. member for Vancouver Centre for bringing the bill forward. The committee took studied bill and decided to report it back to the House with no amendments.

[The Chair, Liberal, Bill Casey]

Ladies and gentlemen of the committee, we are going to do clause-by-clause of Bill S-248. I believe everybody has the bill.

We're going to move right to clause 2. It's very complicated—it's one sentence. Are there any issues with clause 2? Shall clause 2 carry?

(Clause 2 agreed to)

Now we're going to move to clause 3. It's another sentence. Shall clause 3 carry?

(Clause 3 agreed to)

[The Chair, Liberal, Bill Casey]

All right.

I'm going to suspend the meeting for a few minutes because we have to do clause-by-clause on Bill S-248, but I want to thank the witnesses again for their contribution.

You have a very strong message, and we thank all of you for that message.

We'll suspend for two minutes.

National Physicians' Day Act

[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.

[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.

[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 that:

...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.

[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're 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.

The House resumed from April 8 consideration of the motion that Bill S-248, An Act respecting National Physicians’ Day, be read the second time and referred to a committee.

National Physicians’ Day

[Francis Drouin, Liberal, Glengarry—Prescott—Russell, ON]

Mr. Speaker, I am pleased to be here to speak to Bill S-248, an act respecting national physicians’ day.

I would like to begin by commending the Hon. Art Eggleton for introducing this bill in the other place prior to his retirement, as well as the member for Vancouver Centre for sponsoring it in the House.

Bill S-248 seeks to designate May 1 of each year as national physicians' day in honour of the vital role that physicians play in caring for patients and in supporting the health and well-being of Canadians.

A variety of commemorative periods already exist to recognize the contribution of health professionals, such as Family Doctor Week, Oncology Nursing Day, National Physiotherapy Month and Paramedic Service Week. However, these commemorative periods were not proclaimed by a legislative initiative, but were designated through an annual declaration by the Minister of Health.

The approach of this bill to proclaim a national day through legislation for a health care professional is a novel one. As was stated during the debate on the bill in the other place, and as I am sure we all share, we would like to hear more of this in this chamber.

A national day would serve to recognize the phenomenal contributions of physicians. It could perhaps also act as a means of recognizing the growth of the medical profession itself, from a fairly low-skill occupation with little in the way of formal standards or regulations at the beginning of the 19th century to the medicine practised in this new millennium, whose cures astonish and give us hope even in our darkest hours.

However, these considerations aside, I would like to take the opportunity presented by this bill to describe the actions that the federal government already takes to support the work of Canada's 86,644 physicians, 250 of whom I might add are directly employed by the federal government in the Canadian Armed Forces.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Mr. Speaker, after spending eight years in elected politics, including serving in cabinet and running for the Conservative leadership, I will say that I first and foremost always define myself as a physician, a role that I will be returning to full time at the end of this year when I leave this place.

When people ask me what I do for a living, I always say that I am a pediatric orthopaedic surgeon, a doctor who gets to take kids who cannot play on the playground and let them play again, so it gives me great pleasure to rise today to speak to Bill S-248, an act respecting national physicians' day. This act would declare each May 1 national physicians' day.

Children's health has been the primary focus of my medical career, and it was one of the main reasons I ran for office. When asked in 2006 by then minister Jim Flaherty to chair the expert panel on the children's fitness tax credit, I was able to see first-hand how I could have a positive impact on the health of thousands of children via good public policy, not just one child at a time in a clinic. A tax credit to support healthy activities for kids and make activities more affordable for their parents was an innovative idea. It was a welcome idea.

Along with the reduction in the GST, I have heard from many people that this is the most popular and most memorable tax credit of the former government. Not only was it popular, but it was a success. Over 2.8 million children as of 2014 had taken advantage of it. The children's fitness tax credit was so successful that the only criticisms of were that it was not enough and that low-income families should receive a subsidy. In 2014, Conservatives made these changes to reflect what Canadians wanted and deserved.

The success and popularity of the tax credit made it even more puzzling why the Liberals promised to kill it in the 2015 election. Unfortunately, the Liberals kept that promise, reducing it in 2016 and eliminating it altogether in 2017.

One cold comfort is that in 2016, the Children's Hospital of Eastern Ontario Research Institute and other researchers compared Participaction's report card on physical activity for children and youth to 37 other countries in six continents. Canada's highest grade was for participation in organized activities. The report noted that Canada's rates were significantly higher than sports participation rates 10 years ago.

I know that the tax credit was the right policy to help make Canadian kids healthier and for parents struggling to afford sports, so earlier this year I travelled across the country to meet with parents. I wanted to talk to them about preventive health and what we could do to help get kids active.

I continuously heard from parents that they were upset that the tax credit for kids had been cut, so I went to work drafting a bill. On February 6, Bill C-428 was launched, with a website to promote it. I encourage people to go to healthykidshealthycanada.ca to support this initiative and bring back the children's fitness tax credit.

When I heard of the idea of a national physicians' day, I must say I had second thoughts about it. I wondered whether we should we have a day to honour doctors. Most physicians would say that every day it is a privilege to take care of people.

As an orthopaedic surgeon who takes care of kids, I spend my days helping children. Frankly, when children with cerebral palsy walk again for the first time, even with assistance, the joy in their mothers' eyes and their sense of accomplishment and their great smile mean that doctors feel there is no need to be honoured. They know they have played a role in making that happen.

As I looked more into the bill, I began to see why this proposal was being brought forward by Senator Eggleton, with the support of the Canadian Medical Association. A special note is the date, May 1, which marks the birthdate of Dr. Emily Stowe, born in 1831, which several of my colleagues have commented on. Dr. Stowe was the first female to practise medicine in Canada. She was also a pioneer of Canada's women's movement and is an idol for many young Canadian physicians now, particularly female ones.

A national physicians' day is also important because it highlights the role that doctors play in communities across Canada, as my colleagues have also mentioned.

For those who live in big cities, access to care is often taken for granted. However, we do know that in smaller communities, people may not even have a doctor. Those in the north would be lucky to have a nurse practitioner in their communities. Anything more complicated than a broken arm requires a flight to Yellowknife, Iqaluit or Whitehorse, or often a more southern destination.

In the northern parts of many provinces, a doctor may rotate from a southern centre, which is great, but it means that people do not have a family doctor, as they could possibly have in a bigger centre. I say “possibly” because millions of Canadians in communities all across the country lack a doctor.

When places like my community, Simcoe—Grey, lose a doctor in rural parts of the country as he or she retires, we go to great lengths and efforts to recruit a new one, and frequently we cannot. For many communities, the loss of a doctor is like the loss of the post office, the local grocery store or the local school. It is a turning point for a community, and not a good one.

The recognition of a national physician's day gives an opportunity to bring these issues to the forefront at least one day a year. It gives an opportunity to speak to the important roles that doctors play in our communities, of the need for quality care that is accountable and accessible to patients, the ability to talk about lineups and wait times or about how the government demands that everyone use one system and then is unwilling to innovate and change to provide reasonable access to care.

Part of this bargain, the unwritten relationship between citizens and the government that is providing health care, must be reasonable access to care in a reasonable time frame. Currently, this is not the case. This neglect is made worse by the stress that it causes to the patient and to the families of these patients.

I heal kids. There is nothing worse than watching a child suffer, but what the families of these children go through because of the challenges in our system is a really close second. It is frustrating for my colleagues and me to know that we are bound by all sorts of rules that limit our ability to take care of patients. In getting surgical time at a hospital or even opening a clinic, there are many problems.

Just this weekend a colleague of mine, Dr. Smith from Windsor, an anaesthetist, said that the system is broken. The patients know it and the families know it. Why are the politicians and their colleagues afraid to change it?

I heard concerns like this across the country when I was conducting consultations on modernizing the Canada Health Act. Similar views were reflected in reports by Liberal senator Michael Kirby and former NDP premier Roy Romanow about how unaccountable the system has become to Canadians, how out of touch and bureaucratic it is and how the user, the patient, is often the last person of concern.

We need to listen to doctors when they use their collective voices to speak out on issues of national importance. We need to listen when they say that the system is broken, which is exactly what our patients are saying to us every day when they come to a clinic. There needs to be a revolutionary change in our health care system. The Canada Health Act needs to be modernized so that we can provide high-quality care for Canadians, the care they expect and deserve.

Interestingly, one of the most recent and most vocal examples of doctors speaking out was not medically related. It was related to their role as small business owners. Yes, I am talking about the recent tax changes to small businesses that the government introduced. Many Canadians learned during the whole affair that the overwhelming majority of doctors in Canada are small business owners. We are not government employees, which is what the majority of people believe. This misconception is largely owed to the Canada Health Act, which makes people believe that doctors are government employees, but we are not. We are small business owners who have a large amount of overhead and we have to pay for it ourselves. The same expensive equipment that is seen in a hospital we have often have to buy for our clinics. This equipment is not cheap, and it needs to be regularly updated.

Doctors are also substantial employers. Even the smallest doctor's office provides two jobs: an administrative assistant and a nurse. Most provide more, including a scheduler, an office manager and other nurses. A large doctor's office has more full-time jobs than a local café or a small clothing store. These investments in our communities are the reasons Canadians witnessed the negative reaction to the proposed tax changes. Doctors took it as an insult to be called tax cheats by the Liberal government. To be accused of taking advantage of a system by Liberal politicians was a bit much.

Each and every day it is an honour to be a pediatric orthopaedic surgeon. I have an amazing job and I help kids get back on the playground to play. My colleagues and I do not need a day to honour us. However, if a national physician's day can help bring attention to the doctor shortages that Canadians face, to small towns losing their only physician, to the lack of accountability in the health system, to the present model of health care that forces patients into a system where they are simply neglected or to the unfair tax changes that have done nothing more than chase doctors out of this country, then a national physician's day is worthwhile. I am pleased to lend my support to this legislation.

[Brian Masse, NDP, Windsor West, ON]

Mr. Speaker, it is an honour to rise on Bill S-248, an act respecting national physicians’ day.

May 1 would be recognized as national physicians' day. It would be done in memory, which is important for this discussion, of Dr. Emily Stowe, who has been declared one of Canada's heroes. She not only advocated for women's rights but patient rights and the women's movement in general. For her to do this type of trail-blazing was nothing short of incredible. In fact, this bill's having its day on her birthday is very significant and I am quite honoured to talk about that, because the two very much go together.

When we think of how physicians assist patients unconditionally every single day in our society, what they contribute, the difference they make in society and the repercussions of it, whether it be an injury, a workplace accident or violence against people, they see men, women, neighbours, family members, colleagues and fellow citizens from coast to coast to coast and deal with the ramifications, be they health issues that naturally occur because of body changes, repercussions related to the environments people are exposed to, accidents or violence perpetrated against them.

I can speak to the humility of these individuals. I am a PSW, personal support worker, and have experienced some of my most humbling moments while assisting people in vulnerable states, being the last person they see or the only person available to them to get information and try to assist. It can involve things as simple as medication or much more significant things relating to infections and other problems. I would be remiss if we did not talk about the mental health requirements, not only for this occupation but for what doctors deal with in the general population.

Dr. Stowe was an interesting case with regard to Canadian society. To this day, there has not been any type of resolution to equality of any significance. Women still receive less pay than their male counterparts. Women are still subjected to higher rates of violence. Women are still under-represented on corporate boards, not-for-profit organizations and professions. Dr. Stowe actually had to go beyond our borders to make a difference in our country, which, in some respects, sadly, is the case even to this day.

As an example, Dr. Stowe went to the United States to get her medical credentials and professional training, only to return to Canada to have her credentials denied. She fought and eventually had them recognized as part of her accreditation. Ontario and Nova Scotia have already recognized her contributions. As part of her legacy and as a role model for others in our our country, she subsequently went on to work within the women's movement for the right to vote. She became involved in the suffrage movement, which is so important to the national fabric of our country.

This is unfinished business for Canadian society, even today. This legislation would ensure there is a connection between the two in terms of family physicians. Dr. Stowe is very important because there is undoubtedly a connection that should be acknowledged and celebrated and it should be on May 1 that we recognize we need to continue to work on that unfinished business.

Family physicians and other specialized physicians mark our communities very much and in many ways. One could argue that as Canada was settled as a nation, their very presence formed civil societies because of their consistency in being able to serve, whether it was in preventing diseases or assisting individuals with issues related to infections, injuries or birthing. All those different things created the centerpiece for many of our now urban cities. Most importantly, it continues today within our civilization, even as we struggle as a country to continue to provide those services.

It is amazing to think about the long hours that physicians put in as well as the time they give up for themselves, their personal interests and their family members. I am someone who has had the benefit of having a family doctor. Dr. Albert Ng is mine. His father, Edward Ng, was someone who had my grandfather as a patient. I am very grateful to have that privilege to be able to get that type of medical attention, when necessary. It is important to note that many parts of Canada still struggle with this, so hopefully that will be part of this discussion.

As a New Democrat, I can tell the House that it is the unfinished business of Tommy Douglas to have a pharmacare program. However, having accessible and affordable treatment and medical attention is the core principle of where we stand politically, and more importantly, where we should go. That is how we build a strong economy and strong communities, as well as how we better ourselves as individuals.

We know that right now there are many issues in many communities. For example, we could designate a day for mental health. There are other types of addictions and modern society problems, and our physicians are the front-line people who must serve under those conditions. There are many individuals who suffer from these types of different illnesses, and some occur so often that they have become routine in physicians' eyes. However, there are new issues that arise, such as issues related to environmental contaminants in human health, accidents that cause exposure to toxicities as well as a number of different things. Some physicians not only deal with these issues in our own country but go to other countries to help individuals in need. These physicians understand that the human need extends beyond our borders. Canada's contributions are well known and it is something that makes us proud.

If we look at our public policies, one of the most underutilized aspects of our contributions internationally is the DART program, or the disaster assistance response team that is able to go to different jurisdictions. It is an area where we could do much better and it could be used to help in many areas of the world.

In our country, there are physicians who contribute so much and in different ways, and often they are families. In Windsor, there are the Bernstein brothers, one was an orthopaedic surgeon and the other an ophthalmologist. They served patients even into their eighties and made very significant contributions to the community. There are others who serve people and then go on to work as hospital administrators or on developing policies regarding medicines. For example, I think of Edward Ng from my area, who was a physician who went on to help organize the administration practices of very critical medical procedures with regard to the use of spending public money and getting the most out of our dollars. I do not believe that is unusual in places like Windsor, which has large service provisions that undergo changes over the years.

Again, May 1 would be a recognition of the complexities physicians deal with in our society, and not just in regard to treating people. For example, looking again at Dr. Stowe and her contributions, we know that they were very complex. She had a determination to serve people despite the fact that society shunned her for being a female. She was shunned from a profession that was said to be only for males. She had to leave this country to get the accreditation to do the work and then she had to come back and fight for those rights.

These are our men and women who are serving as physicians in our country right now. When we look at the situation with the opioid epidemic, which we believe is a national crisis and needs a national response, often we leave it solely on the shoulders of health care providers to deal with this in a piecemeal way, as opposed to looking at the complex civil society response that is necessary, with the supports for longer treatment. Often our men and women who are physicians end up being the ones who are at the front line.

I conclude by thanking our physicians. May 1 is appropriate because of Dr. Stowe. I want to thank all those participating in making this a day we can celebrate in the future.

[Richard Martel, Conservative, Chicoutimi—Le Fjord, QC]

Mr. Speaker, as we begin our week, I am pleased to speak to Bill S-248, an act respecting national physicians’ day. My Conservative colleagues and I support this bill.

Physicians are a crucial part of our health and social services network. They lead medical teams and take on a lot of responsibility. When it comes to doctors, people have very high expectations. Many doctors are leaders. The people of my wonderful riding, Chicoutimi—Le Fjord, are fortunate to have been inspired by a number of doctors, including Dr. Stanley Vollant while he was with general surgery services at the Chicoutimi health and social services centre.

Dr. Vollant is a deeply compassionate person. I know him very well and enjoyed many conversations with him while I was working in Baie-Comeau. He is the first indigenous surgeon in Quebec and the second in Canada. In 2010, he began the Innu Meshkenu, a 6,000-kilometre trek along the trails trodden by his ancestors, to share his message of hope and perseverance with young indigenous people.

He reminds us that we must invest to develop the full potential of young people so that they never give up on their dreams. He believes that a large part of the health care budget should go toward education. Through his words and his actions, he is sharing a message of pride in indigenous culture and of the importance of staying in school and adopting a healthy lifestyle.

I would be remiss if I did not also mention the participation of the Fédération des médecins omnipraticiens du Québec in the Grand défi Pierre Lavoie, a man from my riding, and Dr. Dominic Gagnon's determined promotion of healthy living. The Grand défi Pierre Lavoie is a 1,000-kilometre cycling marathon over 60 continuous hours from Saguenay—Lac-Saint-Jean to Montreal to promote healthy living.

The Grand défi Pierre Lavoie also funds a foundation by the same name, which seeks to develop, support and promote any activity that encourages people, particularly youth, to adopt a more active lifestyle. Physical activity is a great way to prevent many major diseases. The aging population and the rise in obesity will impact social services and health. I join with the foundation in stating that curative care is just one part of the solution. Prevention is the other.

The benefits of a healthy lifestyle are not simply limited to weight management. They play an important role in the prevention of certain cancers and cardiovascular diseases, stress management, and fostering well-being and self-esteem as well as the ability to focus and learn.

Working in health care is becoming increasingly complex. We need the leadership of doctors. I appreciate and acknowledge the leadership of my colleague from Simcoe—Grey. She is a pediatric orthopaedic surgeon and a parliamentarian. She continued to practice medicine while an MP. She did not hesitate to go to Nepal in 2015, not as a government representative but to offer her know-how in an effort to help the victims of recent earthquakes.

As I was saying, there have been many changes in medicine, especially technological changes. Could the use of artificial intelligence ultimately eliminate the radiology profession? Scientific research improves treatment effectiveness. Then there are social changes. Canada has an aging population. One in four people will soon be a senior. Health care, like so many other fields, is grappling with a labour shortage. There is also a shift in ethics. On June 17, 2016, Canada passed legislation on medical assistance in dying. There there are physical changes. Bacteria are increasingly resistant to antibiotics.

When we recognize the contribution of doctors and their leadership, we also recognize the work of all stakeholders in the health sector.

These changes underscore the importance of teamwork and greater responsibility and knowledge sharing. In health care, every person has a role to play. Everyone contributes.

This bill would designate May 1 as national physicians' day. During the week of May 12, we honour nurses for the work they do. As team leaders, physicians have to deal with a lot of pressure and meet numerous modern-day challenges.

Canada's emergency rooms are often full to bursting, and patients can spend a long time waiting. Because of the aging population, our communities' needs are growing, especially the need for palliative care. More and more Canadians are requesting medical assistance in dying. Physicians are running up against “Dr. Google” as patients research their symptoms online to come up with their own diagnoses. The Internet and misinformation also increase the pressure on physicians. The World Health Organization lists vaccine hesitancy as one of the top 10 threats to world health in 2019. People are more afraid of the vaccines themselves than the diseases. Anthropologist Heidi J. Larson, an expert in risk science at the London School of Hygiene and Tropical Medicine, warns that the next major outbreak could be caused by misinformation. Some people also believe that doctors are paid too much. The media attacks doctors for salary increases granted by the Quebec government. Changes made to the tax system during this Parliament have penalized doctors, unfairly tarring them with the same brush as taxpayers who use aggressive tax planning.

Incidentally, these tax changes also threaten the forestry co-operatives that are so common in the regions of Quebec.

This can upset the fiscal balance relative to that of the United States. We need to show greater support for our physicians, so they are less inclined to go and practise their profession in the U.S.

The professional oath of the Collège des médecins du Québec stipulates that physicians must discharge their professional obligations towards all patients with competence, integrity and loyalty. Their professional conduct must comply with the principles of the code of ethics. They must be loyal to their profession and respect their colleagues, and always behave in keeping with the honour and dignity of the profession.

The member for Markham—Stouffville did not want to leave her position at Treasury Board. She was even more upset when she was kicked out of the Liberal caucus. Some members have publicly accused her of disloyalty. She was the victim of attacks based on inaccuracies and falsehoods. As a physician and an MP, she aimed to improve the lives of Canadians. She upheld her fundamental values, her ethical responsibilities and her obligations. Now she is paying dearly for that.

This government definitely needs to recognize national physicians' day. These individuals are true community leaders. Many of them are very involved in their communities. They are economic drivers in smaller communities and, more importantly, they save lives.

[Hedy Fry, Liberal, Vancouver Centre, BC]

moved that Bill S-248, an act respecting national physicians’ day, be read the second time and referred to a committee.

Mr. Speaker, I want to thank my colleague from Ville-Marie—Le Sud-Ouest—Île-des-Soeurs for seconding this bill.

It is a pleasure to stand here to speak to a very simple, short, one-line bill, which says that we would like to name May 1 as “national physicians' day”. Why would it be the first of May? It is because May 1 was the birth of the first female physician, in the 1800s. She graduated in New York and came to live here because she was a Canadian woman from Toronto. Her name was Dr. Emily Stowe. She was not able to study here, so she had to go to New York to get her medical degree. Therefore, the medical profession would like her birthday to be the day that we celebrate national physicians' day.

Not only did Dr. Emily Stowe come back here to become a very prominent suffragette, but she also helped to create what we now call the Women’s College Hospital, so that women, unlike herself, could now study in Canada. That is one of the reasons we are naming it national physicians' day on May 1, because of Emily Stowe.

However, I want to talk about why there should be a physicians' day. I am a physician. I studied medicine in Dublin, Ireland. I came to live here in Canada. I practised medicine for 23 years, delivering over 800 babies. That was a remarkably wondrous time in my career, because I loved delivering babies. I loved getting up at two o'clock in the morning and rushing out to deliver a baby. It was always a great feeling, but sometimes it was not.

Sometimes babies were born with problems. That was really hard, after working with a mother for nine months, to get to the point of knowing what she was facing with the birth of her child. Physicians do that every day. They see that people get sick. Sometimes we cannot help people. All in all, that is how physicians spend their days. I do not think there is anybody in this place who has not at some time or another seen a physician.

For me, being a physician was a remarkable time in my life. However, I want to point out how many physicians not only look after patients to try to prevent them from getting sick, but also look after patients when they are dying or going through difficulties with Alzheimer's disease. That is what physicians do.

There are still physicians in this country who are making house calls. There are about a million house calls a day in this country made by physicians. It was something that I liked to do, because I got to visit my patient's house. I saw the way that they lived, and it helped me to understand better what was going on in their lives.

As physicians, we are not only involved in healing the sick, helping people to get better and preventing people from getting ill, but advocacy is a major thing for physicians. When I was a member of the British Columbia medical association, we worked really hard to get infant seat restraints. We pulled all kinds of stunts to get the government of British Columbia to enforce them. In fact, we had a poster that said, “Did you belt your kid today?”, and there was a Canadian seatbelt sitting in his or her little chair. We also worked hard to get people to wear bicycle helmets. We were again trying to make people take notice. There was someone riding a bicycle with a watermelon that fell off and splattered, and it said, “You have to wear a helmet. Protect your melon.”

There are all kinds of things that one had to do as a physician to move that agenda forward, to try to speak for patients. Many times patients are vulnerable and do not have a voice to speak for themselves. This, for me, is the essence of being a physician. It is not just studying for seven years and then doing two years of residency and finally practising medicine. I knew all about the science of medicine, but it is my patients who taught me the art of medicine. It is my patients who helped me to understand what being a physician was really about. It is going to bat for your patients and trying to get the best for them. Considering the best interests of your patients is one of the things that we believe in as physicians.

Then, of course, my patients also taught me. Patients taught me not to judge them but rather to help and do my best for them, regardless of my religious or moral beliefs. It was not about that; it was about doing the best for my patients. It was to support them through all of their decision-making to help make their lives better.

As a family doctor, it was about getting to know the patient's family. It was about making sure that we knew that the family itself was at the heart of what made the patient tick, what made the patient who he or she was. Sometimes when we were trying to deal with a patient's ailment, we had to deal with the family. We had to look at the family dynamics. We had to do the kind of stuff that we never think physicians have to do.

That is why I want to talk about some physicians I know very well in British Columbia, who have put themselves on the line. They do not get paid for it, but they push hard. I want to talk about Dr. Julio Montaner, from the Downtown Eastside, where he has worked with people who are addicted, who have overdosed and who have HIV-AIDS or hepatitis C. All of those people that the world tends to forget or are judgmental about, he has put himself on the line for, pushing for those things.

Dr. Jerilynn Prior, who is a friend of mine and a colleague, at one time pushed for women to take folic acid so that their children would not be born with spinal injuries. Today, she is pushing for dying with dignity, as she herself is in a wheelchair with an intractable disease.

I could go on and on about all of the things that physicians do other than just looking at us when we are sick.

I know how many funerals I have attended as a physician, how many births and many marriages. I know how many women have called me in the middle of the night because they were scared. They were locked in their bathroom because their husband was outside screaming at them with a baseball bat because he had come home after drinking too much. Sometimes, I have found them places to keep them safe.

For me, this is what a physician is about. Therefore, we are asking for everyone in this House to support the concept that on one day in the year we celebrate physicians for the work they do, their integration into our families and lives, and to ensure that this country has physicians. Family physicians take care of about three-quarters of patients and their needs.

We talk about gender equality a lot in this House. Two-thirds of family physicians are women. We now see them enrolling in university to study medicine and graduating across the board as specialists and the like. In fact, we now have about 45% of women who are physicians. Therefore, we have come full circle, in talking about how being a physician is really important, how many of us depend on physicians when we are helpless or in need and the trust that we put in physicians. Being a doctor is one of the most-trusted professions in the world. I think that this tells of the relationship we want to celebrate when we talk about physicians day on May 1.

Therefore, I hope I can get support from this whole House to designate May 1—and perhaps, because I know it is just around the corner, this coming May 1—as the day we stand in this House to declare the very first national physicians' day.

[The Chair]

There are two bills in the chart of items added to the order of precedence: Bill S-243, from Pat Kelly, and Bill S-248, from the Honourable Hedy Fry.

Have you had an opportunity to read them over?

[Hedy Fry, Liberal, Vancouver Centre, BC]

moved that Bill S-248, An Act respecting National Physicians’ Day, be read the first time.

Mr. Speaker, I want to thank the hon. member for Charleswood—St. James—Assiniboia—Headingley for seconding this Senate bill.

It is self-explanatory. Physicians have existed as an entity in this country since the inception of Confederation. They have done great work. They have helped in saving lives and have been dedicated to this goal. It is time we honoured them on a particular day.

(Motion agreed to and bill read the first time)