Good morning, Madam Chair and honourable members of the committee. Thank you for the invitation to appear before you today.
My name is Dr. Sarah Giles, and I'm the president of the Society of Rural Physicians of Canada, the SRPC. The SRPC represents 3,000 physicians and medical learners who provide care to the roughly 20% of Canadians living in rural, remote and indigenous communities.
I'm a rural generalist in Kenora, Ontario. On any given day, my colleagues and I might be in primary care clinic in the morning, in an overflowing ER in the afternoon and in the OR at night.
As you know, rural Canada is the literal engine of our national economy. It contributes 27% of Canada's GDP and accounts for 53% of our merchandise exports, but right now, Canada's economic engine is on life support. While roughly 20% of Canadians live rurally, they are served by only 8% of the country's physicians. As a result, rural Canadians face shorter life expectancies, significantly higher rates of chronic disease and lower cancer screening rates.
The federal government has rightly prioritized multi-billion-dollar nation-building initiatives in remote Canada to secure our global competitiveness. The success of these massive public and private investments depends entirely on our ability to attract and retain highly skilled workforce members in rural and remote regions, but few people or businesses want to relocate to a region if there isn't reliable primary and emergency care for their family members. We need to keep rural clinics and hospitals open for current and future community members.
To do this, we need to transition back to a safe and stable workforce of rural generalists and nurses who both live and work in communities. Resuscitating rural health care will also require infrastructure funding, and allow me to pre-empt any thoughts that health is solely a provincial or territorial responsibility. The federal government is responsible for funding and delivering health care services in indigenous communities, and rural hospitals are more likely to serve indigenous patients, as they comprise a large portion of the rural and remote population.
Right now, there are hospitals in rural Canada facing catastrophic infrastructure failures. Hospitals have, for example, flooded and subsequently all but shut down surgical services. Closing essential services forces patients to travel hundreds of kilometres and to wait unacceptable periods of time for care that should be offered close to home.
Though critical infrastructure issues are putting rural indigenous patients' lives at risk, rural hospitals are often jurisdictional hot potatoes when it comes to funding new facilities. The provinces don't want to foot the bill for indigenous patients, and the federal government doesn't see building hospitals as its mandate.
By appealing to the nation-building goals of the federal government, I hope to move you to invest in closing the infrastructure gap faced by rural hospitals primarily serving indigenous people. The federal government can do both what's right and what is necessary.
At SRPC, we believe we know how the Government of Canada can help.
One, invest in skills and training. We request $25 million over three years to scale up our national advanced skills and training program for rural physicians. Our initial pilot program trained 342 physicians across 187 rural and indigenous communities. We secured essential emergency anaesthesia and obstetrical training for more than double the number of physicians we initially estimated. It is far cheaper to retain our rural doctors than it is to recruit new ones.
Two, establish a pan-Canadian rural and remote health workforce strategy. We urge the federal government to partner with the SRPC to build an interdisciplinary workforce strategy to address critical gaps in the workforce. How can we possibly know how many health professionals to train or recruit through immigration when we have no idea of the current and future need?
Three, secure a rural and indigenous health infrastructure carve-out. We recommend ensuring that the federal health infrastructure fund include dedicated rural and indigenous streams to support the unique needs of these communities. We must stop the jurisdictional finger-pointing and prioritize integrated primary care, mental health services and emergency care, including obstetrics, for rural and indigenous communities.
Finally, mandate a HESA study. We ask that the Standing Committee on Health conduct a comprehensive study on the unique primary and emergency needs of rural Canada, to assess scalable national solutions.
Honourable members, investing in rural communities is not an act of charity; it is a strategic national necessity. By supporting these targeted recommendations, this committee can help stabilize our workforce, protect our supply chain and fulfill the Canada Health Act's promise of health equity for all Canadians.
Thank you.