Thank you.
We're all here trying to address the problem of shortages in the workforce in health care. Certainly, Dr. Maguire has talked about the possibility of using more foreign graduates.
I guess I'm the old man here of the group of doctors. I graduated 36 years ago. Do you know what? Absolutely nothing has changed in 36 years with respect to licensing foreign graduates. They've been around and a number of us have worked in areas.... I've worked most of my life in under-serviced areas and there have always been a lot of foreign doctors in Canada who we could, should we wish to, provide with a pathway to upgrade their skills if necessary, so they can practice in Canada.
Why hasn't it happened in 36 years?
I'm looking across at a couple of other doctors here who are in a similar situation. They, too, have worked in under-serviced areas. I'm frustrated with this. We talked about differences. Dr. Lefebvre, I think, talked about bringing people to the right level, but she's an obstetrician. I've done Caesarean sections myself in developing countries. I know there are a lot of foreign grads who can do better Caesarean sections than Canadian doctors.
If necessary, we can train people, get them up to the required level in order to practice in Canada. What has been the problem?
I would suggest that—and I want to ask a whole bunch of you—there are a number of possible problems.
One is protectionism. Organizations like the CMA and OMA represent all doctors. Yes, doctors in rural areas want to attract more foreign graduates, but I've also done a little bit of work in big centres like Toronto. Do you know what? They don't have enough patients in those places, so they're trying to get people in. If you're a doctor in a big centre, you may not want to license a lot of foreign doctors because that's more competition for you and a possibility you will earn less income. So, I'm suggesting maybe there's some protectionism amongst the medical profession in not making it easier for foreign doctors to get work here.
The second thing is the possibility that the provinces don't want to have more billing numbers because that means higher cost. Third is the problem of colleges and the real kind of problem in that they don't meet the same standards as we do. Fourth is the problem with us and the federal government in immigration.
Dr. Maguire, maybe I can start with you and then I'll pass it on to the College of Family Physicians of Canada and the Royal College. I note that neither of those two bodies mentioned increasing the use of foreign doctors.
Dr. Maguire, maybe we can start with you.