Thank you, Madam Chair.
I appreciate the opportunity of appearing before you. I have Cecelia Li with me, whom I dragged into this. She's a medical student who's currently doing a rural rotation in Shawville, just down the road. She's part of the group that is the relief, the cavalry coming over the horizon, and we hope to interest her in rural practice. She brings a fresh set of eyes to the problems.
I've been in rural practice for 25 years. I'm the president-elect of the Society of Rural Physicians, and there are other members, colleagues of mine, across the country. When I got the the invitation to come to speak to you, I put out a call to my colleagues to give me some front-of-the-line reaction to the question of preparedness in their communities. This is unavoidably a bit anecdotal, since we haven't done a scientific survey. But I heard from people working in first nations communities and from health care teams in more southern rural communities. I'll list them for your interest. I heard from people in Lacombe, Alberta; La Loche and Wynyard, Saskatchewan; Sioux Lookout, Haileybury, and Smiths Falls, Ontario; Invermere, the Queen Charlotte Islands, Fort St. John, and Golden, B.C.; Glenwood and Freeport in Nova Scotia; and Goose Bay, Labrador.
As a general impression, what I heard was that there are preparations being made. Nevertheless, they are being added to from the shortages that already occur, and these are mostly human resources shortages of nurses, physicians, and other health care providers. In some places, it's going to make a difficult situation worse.
The one that worries people is that if the pandemic, as it has in the first wave in some communities, produces large numbers of people who require intensive care, transport, and facilities to care for them, things will become very difficult. This is why the Society of Rural Physicians has for many years lobbied for increased education of physicians who intend to practise in rural areas. We favour dedicated rural streams so that the skills required to look after patients close to their home communities can be strengthened. This way, when difficult times arise, particularly difficult times when everybody's in the same boat, some of those skills can be applied where the people live.
One of the other comments that I got from rural communities is that we shouldn't lose perspective on this pandemic. Many public health experts are still not sure what the severity of H1N1 will end up being. Communities that have a lot of other essential services to provide need to be able to continue to provide them. Physicians are also telling me that it's a wake-up call. We haven't been paying attention to infectious diseases in other years in the way we should have. It's well known that seasonal influenza also causes a lot of morbidity and mortality among slightly different demographic groups. But because these epidemics are not so widely publicized, not as much effort is put into combatting them. I think they are saying yes, H1N1 is a significant problem and we have to respond to it now, but let's not pack that experience away into a suitcase afterwards; let's learn from what we've had to do to combat this one.
Another possible perspective of interest to committee members is the federal-provincial one. As you know, health is a provincial responsibility, so all the provinces have rolled out slightly different pandemic plans, slightly different vaccination strategies, and slightly different target groups. For people who live on borders and for physicians who communicate amongst themselves across borders, that produces a fairly confusing picture. I work in Shawville, which is just up the river from here in Quebec, and my patients are very confused, because the news they hear is about the Ontario program, which is vaccinating with a different vaccine for the seasonal flu, and at a different time than Quebec has chosen. I'm not here to debate who's right; I'm here to assert that the plethora of different programs is guaranteed to cause confusion, both in health care providers' minds as well as in patients' minds.
I'd make the comment that the need to do all of this province by province must in the analysis have led to a great deal of wasted—or not wasted, but certainly duplicated—effort. Perhaps there's a lesson to be learned from this about a more coordinated planning process.
I mentioned the worst-case scenario, the concerns about there being a lot of people requiring ICU care. Already in Quebec they're talking about 200% to 300% of ICU capacity being reached. That's going to stress rural physicians with limited resources and limited backup, if we come to that point.
Looking into the future, there are some things that the Society of Rural Physicians is very interested in pursuing. One is ensuring that at times like these there are adequate human resources in rural areas. It's an ongoing issue. We've worked very hard to make the case that the quality of care provided in rural Canada should not be different from the quality of care provided elsewhere, but only organized differently; and that the providers of that care need to be educated differently, and that we need a presence in the universities and in the residency programs and in our teaching communities to ensure that this happens.
Finally, I think I can guarantee for you that rural physicians have community connections second to none and that they will step up to the plate and do whatever is required under the circumstances. Hopefully, we'll come out of this stronger than before.
Thank you.