I think strong leadership means setting a goal or vision. The federal government could say: we're interested in investing in collaborative teams, working at the full scope of practice, to ensure that all Canadians have access to quality care in the most appropriate setting as close to home as possible.
I think those three things define a whole different thing. For example, the Ottawa Hospital has a relationship with Nunavut. In the case of providing quality care in the most appropriate setting as close to home as possible, clearly we can't set up a heart transplant program or a major complex surgery program in Nunavut, so the investment in health human resources would be more in transportation and transport workers, to get them to the most appropriate place as close to home as possible.
At the secondary care level, with generalists and consultants, we send providers up there, which I think is more appropriate than trying to staff a rural or northern area that can support one-half or one full-time equivalent. It won't work in those groups, so send providers of care. And on the primary side, use more technology and full scopes of practice to provide primary care.
If you took that model across Canada and looked at urban-rural relationships and urban-northern relationships, the health human resource plan would be very different from what it is today. It takes several years—14 or 15 years—to create a physician. We're talking about providing enough people for a service delivery model that I hope is not based on the status quo 15 years from now.
Putting a stake in the ground saying that we're only supporting collaboration and collaborative teams, that whether remote, urban, or local, we have to start working in teams, is the only way to sustain it. That's what health human resources should be based on.