Health Committee on Nov. 6th, 2025

[Krissy Bell]

You do, yes.

[Doug Eyolfson, Liberal, Winnipeg West, MB]

All right. If there were a nationally recognized licence for physiotherapists—as we've been talking about for physicians—would that improve matters?

[Krissy Bell]

Absolutely. Even if you use examples.... With regard to physiotherapists, people think about sports right away. You think of a university sports team and a student seeing a physiotherapist as an elite-status athlete. The student will see the same physiotherapist for the entire school year. Then the student goes home and can't see that physiotherapist anymore. That physiotherapist can't treat the student anymore, because the student has crossed a border, an artificial line, which makes it so that the physiotherapist can't work with this student through the summer months.

With regard to practice borders, even here in Gatineau-Ottawa you need to be licensed in multiple jurisdictions.

[Doug Eyolfson, Liberal, Winnipeg West, MB]

Thank you.

Dr. Amiri and Dr. Hulko, I understand your frustration with this. I've been watching this. We've been hearing much testimony about these things.

I do want to clarify. In Ontario, the restriction is that you cannot apply for a residency in Ontario unless you've gone to high school there.

[Ali Amiri]

Exactly. That is correct.

[Doug Eyolfson, Liberal, Winnipeg West, MB]

All right.

I know this is a rhetorical question: Can you think of any public good that was accomplished by this rule?

[Ali Amiri]

I tried so hard, to be honest.

We, of course, understand that we want Canadians to come back home and serve their favourite people. That's definitely understandable. However, why are we not opening new opportunities for everyone to apply? Why take it from someone and give it to someone else when you can bring more opportunities for everyone, especially at this time when Canada needs physicians?

[Doug Eyolfson, Liberal, Winnipeg West, MB]

Absolutely, yes.

Mention was made of the CaRMS. Are you still eligible to apply for a CaRMS match if you rank residency positions in other provinces?

[Ali Amiri]

Actually, we have very few positions across Canada. I think that, out of 4,000, we have fewer than 180 positions across Canada. The majority of positions were in Ontario, and now we cannot apply for them. For the province of Alberta, you need to be a resident of Alberta in order to apply. For British Columbia, you need to get an invitation to apply.

If you exclude all of those things.... For those living in Ontario, they have less than 100 positions all over Canada, and there are thousands of applicants.

[Doug Eyolfson, Liberal, Winnipeg West, MB]

It's very unfortunate. I've watched this myself.

Would you support a national organization—an umbrella organization—that would facilitate this, as opposed to having to rely on different provinces' regulations?

[Ali Amiri]

Definitely.

[Doug Eyolfson, Liberal, Winnipeg West, MB]

I agree.

I have another rhetorical question.

I've spoken on this myself. I practise in Manitoba. I could drive two hours to Kenora, Ontario. They're sometimes short in their emergency department. I've often had the time to do it. I have to jump through all the hoops to apply for an Ontario licence and then pay $2,500 to $3,000 per year to maintain it.

[The Vice-Chair, Conservative, Dan Mazier]

You have 10 seconds, Doug.

[Doug Eyolfson, Liberal, Winnipeg West, MB]

Thank you.

Would you agree that it would also improve the situation if licences were recognized across the country?

[Ali Amiri]

Definitely.

[Antanina Hulko]

Absolutely.

[Doug Eyolfson, Liberal, Winnipeg West, MB]

Thank you.

[The Vice-Chair, Conservative, Dan Mazier]

Thank you.

Mr. Thériault, you have two and a half minutes.

[Luc Thériault, Bloc, Montcalm, QC]

I would like to continue in the same vein as my colleague, who often asks this question.

Obviously, when it comes to Quebec, there is an additional problem. There is a shortage of physiotherapists and doctors. If we allowed people to practise in one province or another, would we be robbing Peter to pay Paul? If we did that, what would it achieve? It wouldn’t solve the problem. The shortage is everywhere. We’re not talking about crossing the Champlain Bridge from Gatineau to practise in Ottawa and coming back to sleep in Gatineau at night. That’s not what we’re talking about.

I would like to understand how the mobility of doctors or physiotherapists would solve the problem. It may be a short-term solution, but not a long-term one. There is a shortage.

Ms. Bell, I’ll let you respond.

[Krissy Bell]

I think there's a short-term solution in preventing any barrier to care for a patient, especially when it comes to rural and remote communities. Even in northern Quebec, you may have a fly-in community that would benefit from physiotherapy services delivered by a physiotherapist in a different province, like Ontario or the Maritimes: They could fly in, offer services for several days and then fly home. From home, they could virtually continue to care for and assess those patients who live in those fly-in communities in northern Quebec. This would be an example of expanding access by utilizing health care practitioners who may be in more urban centres.

There's an opportunity because physiotherapy has less complexity than the physician space does. We're hearing a lot about the complexity of the examinations, given the nature of the role of the physician. For physiotherapists, there's an opportunity for us to immediately make an impact on the delivery of care to Canadians because their scope can reduce the requirement for utilization of physicians. They can reduce the volume of issues in emergency rooms, etc.

I think both things are true at the same time. I do think national mobility is an important next step in ensuring equitable access for Canadians all across the country, but that alone is not the solution, for sure.

[The Vice-Chair, Conservative, Dan Mazier]

That's great. Thank you very much.

Thank you, Mr. Thériault.

For five minutes, we'll go to Mr. Bailey.

[Burton Bailey, Conservative, Red Deer, AB]

Thank you, Chair.

Ms. Bell, in your opinion, is the health care system in Canada in crisis?

[Krissy Bell]

Yes.

[Burton Bailey, Conservative, Red Deer, AB]

Does population growth impact the demand on the health care system?

[Krissy Bell]

Yes.