Evidence of meeting #11 for Health in the 45th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was across.
A video is available from Parliament.
Conservative
Conservative
Burton Bailey Conservative Red Deer, AB
Should Canadians who have been medically trained in other countries be given priority should they wish to return to Canada and work in health care?
Chief Executive Officer, Canadian Physiotherapy Association
Yes. I think there are benefits to adding Canadians who have skills we require to support infrastructure in Canada.
Conservative
Burton Bailey Conservative Red Deer, AB
Thank you.
Ms. Madhany, would a standardized national licensure system for health care professionals be a net benefit to Canadians' health care?
Managing Director, Canada and Deputy Executive Director, World Education Services
Absolutely. In terms of the population decline we have in Canada, we have fewer children, we have retirements and we have an aging population. Yes, a standardized system would help Canadians.
Conservative
Burton Bailey Conservative Red Deer, AB
Have you been consulted on immigration numbers entering Canada and the potential impact on health care here?
Managing Director, Canada and Deputy Executive Director, World Education Services
As part of the consultation process that IRCC does, yes, we were part of a consultation process, but it was a broad question around the numbers of immigrants we want to bring in. It wasn't, “Do we need to bring in more health care workers?”
Conservative
Burton Bailey Conservative Red Deer, AB
Can you elaborate? Yours is the first organization that's been consulted on immigration, so I'm curious to learn a little bit more.
Managing Director, Canada and Deputy Executive Director, World Education Services
Sure. As part of the immigration legislation, IRCC goes across the country and basically consults on the number of immigrants they could bring into the country, what the labour market shortages are and the mix of immigrants: economic immigrants, humanitarian and family class. On that basis, it's a conversation that happens across the country, and then it comes to cabinet by early November to talk about the number of immigrants who will come and what classes of immigrants they will be.
That's the consultation process the government has to do as part of the legislation, and WES was consulted as part of that particular process.
Conservative
Burton Bailey Conservative Red Deer, AB
Okay. Can you tell me of any other consultations? In Ireland and in other countries, we have Canadians who have gone and gotten their medical education. My understanding is that your organization is helping them get back to Canada and get employment.
What consultation has the Department of Health or other organizations had with you in getting more spots set up for them? Has there been any consultation in that regard?
Managing Director, Canada and Deputy Executive Director, World Education Services
My organization assesses the academic credentials. That's the only component we do for immigration purposes. When somebody chooses to come to Canada, that's what we do, the academic component, not for licensing for health professionals.
Conservative
Burton Bailey Conservative Red Deer, AB
Should these not take place before they come to Canada? Should we not be meeting with these students or trained medical professionals—with Dr. Hulko, for example, so that before she came she would know what she was up against?
Managing Director, Canada and Deputy Executive Director, World Education Services
That's federal jurisdiction and a federal responsibility. The information that's given to potential immigrants should be very clear in terms of what the steps are to get licensed in a particular occupation. That information is fragmented right now. It isn't easily available. You end up with a fragmented situation in terms of what it takes to come here as an immigrant. There's a separate information piece in terms of what it takes to get licensed in a province. Then there's a separate piece when you go to a particular occupation.
Conservative
Burton Bailey Conservative Red Deer, AB
Thank you.
Dr. Hulko and Dr. Amiri, I want to thank you both for the work you do with Catholic social services. I'm quite aware of the organization. I don't want my opening comments to reflect the work you do there. The accusation that was made by the government is what I wanted to address before this meeting.
I really feel for you, Dr. Hulko, being a female surgeon in what they refer to as the “old boys' club”. I'm really struggling with why you can't be practising as a surgical assistant. Can you elaborate on why you cannot be a surgical assistant? My understanding is that when you want to get into a residency, you need to be working in the hospital to get to know the doctors so that they give you the approval.
Conservative
International Medical Doctor, Catholic Community Services of York Region
Speaking practically, it's almost impossible to get this position. That's it.
Conservative
Liberal
Sonia Sidhu Liberal Brampton South, ON
Thank you, Mr. Chair.
I'd like to thank all the witnesses for their insightful testimony.
Ms. Bell, you said there should be more bridging programs. There should be more programs for physiotherapists, because there's a physiotherapist shortage too. In this budget, $5 billion over three years, starting in 2026-27, will be dedicated to the health infrastructure fund. Do you think this fund will complement existing health-related...? Health care delivery comes under provincial jurisdiction. Do you think this fund will be beneficial for the bridging program and how the province wants to do that?
Chief Executive Officer, Canadian Physiotherapy Association
For sure, I think there's opportunity within any health investment, in particular in infrastructure, in centring consideration of all the professions on the health care team. If the infrastructure fund is utilized in a way that supports team care and advances first-contact physiotherapists, I absolutely think it could be supportive in addressing some of the barriers, including if it added national seed funding for bridging programs.
I don't have specificity around how that fund will be used, but I do think that investments in health care, as long as they prioritize consideration of the full scope and capabilities of all the professions on the health care team, and they really try to leverage the full weight of the work in the labour force, could definitely support advancing physiotherapy.
Liberal
Sonia Sidhu Liberal Brampton South, ON
What role can provincial ministries and health authorities play in addressing this gap?
Chief Executive Officer, Canadian Physiotherapy Association
There are a lot of things that provincial health authorities can do. In particular, we advocate strongly for a nationalized scope of practice for physiotherapists.
Currently, from jurisdiction to jurisdiction, provincially, the scope of physiotherapists differs. If you're a physiotherapist who works in Alberta, you can order diagnostic imaging, but if you're a physiotherapist who works in Ontario, you can't. That causes a lot of backlogs and it actually increases the demand on the physician. If you go and see your GP and say you've hurt your knee or your back, they might say, “Go and see a physiotherapist,” but the physiotherapist will say, “You need an X-ray or an MRI. You have to go back to your general practitioner to get a referral, because I am not able to refer for that image,” even though it is within the competency profile in the nationalized competencies of a physiotherapist.
Recognizing the full scope of the physiotherapy profession across the country would be a massive advancement for each jurisdiction, whether that's in diagnostic imaging, the ability to refer to specialists or some of the prescribing pieces we see. We strongly advocate for a nationalized scope.
It would also support our physician colleagues. If our physician colleagues are trained and work in Ontario and they're used to their physiotherapy peers not being able to order images, and then they go to Alberta, the job of their colleagues and peers has changed because they have changed jurisdictions. As part of that consideration of mobility across the nation, a fully recognized scope of the competencies of a physiotherapist is critical.
Liberal
Sonia Sidhu Liberal Brampton South, ON
Do you think there should be pan-Canadian guidelines? It's not like in Alberta. There are different procedures or guidelines to follow. How do we address this barrier? What should be done?
Chief Executive Officer, Canadian Physiotherapy Association
I think pan-Canadian guidelines are a solution. We have a very amicable relationship right across the country. Physiotherapy is quite a happy family, and we work well with our regulator partners and provincial partners across the provinces. Having consistency across those regulations, whether it's through the existing bodies or some kind of pan-Canadian framework, would for sure be a solution to ensure the full utilization and the full economic benefit of using physiotherapists and reducing the burden on the health care system.
