Good morning, honourable members.
Let me begin by thanking you for the opportunity to appear before your committee to speak on behalf of the Society of Rural Physicians of Canada. My name is Michael Jong, and I am a rural physician in Goose Bay, Labrador. I am the president of the Society of Rural Physicians of Canada.
I am joined here today by two other members of our society. Dr. John Wootton is a rural physician in Shawville, Quebec, editor of our Canadian Journal of Rural Medicine and former director of the office of rural health at Health Canada. Dr. James Rourke was a rural doctor in Goderich, Ontario, for 25 years before becoming dean of Memorial University's medical school here in St. John's.
The Society of Rural Physicians of Canada is a voluntary professional organization and national voice for Canadian rural physicians. I consider it a privilege to be here today to speak to you regarding human resources solutions to rural health access problems.
You may wonder why I'm here today. I and my rural physician colleagues are faced on a daily basis with the sad realities of limited access to health care in our rural communities. I know some honourable members with rural constituencies who are very familiar with this.
Let me give you some examples. I had a patient who preferred to die rather than relocate to get dialysis. I've had patients who've had to mortgage their homes in order to continue to receive cancer care in a faraway place, without the support of their families and friends. Mothers and babies in rural remote communities are routinely evacuated from their homes, their families, their communities, their culture, and their support systems so that they can be assured of appropriate care during childbirth. Women who are 35 or 38 weeks pregnant have to leave their loved ones behind and travel somewhere else for what is the most important time of their lives, sometimes for as long as eight weeks.
Rural health is in need of repair. The Centre for Health Information's report in September 2006 on the health of rural Canadians shows that rural residents have higher mortality rates and shorter life expectancies. Those living in the most remote communities are the most disadvantaged. Life expectancy is lower in rural areas as compared to urban areas by as much as three years.
Health care access is a major concern for rural Canadians. While 31% of Canadians live in rural areas, only about 17% of family physicians, and 4% of non-family medicine specialists, practise there. The rural problem is one of access.
Urban-focused approaches, such as the wait times strategy, have made important gains in reversing some of the efficiency losses caused by reductions in operating times and days. These measures have limited or no rural impact, where the system is already very efficient. Although the rural population has poor health status, the cost of capital in dollars spent on the health care providers engaged is well below urban standards.
Dealing with this issue is the most complex and challenging aspect of health care policy. Mr. Romanow suggested that we devote $1.5 billion to developing a comprehensive rural health access strategy. To be fair, a significant commitment is needed to address this problem. However, significant gains can also be made on an incremental basis.
To build a strong link between rural health and the national economy, we cannot ignore the link between health care and the sustainability of rural communities. Having access to health care is important in ensuring that people will be willing to live, and companies will be willing to develop industries, in rural communities.
From a sovereignty, self-sufficiency, and economic perspective, rural depopulation has negative long-term implications for our country. The primarily rural-based natural resources sector accounts for approximately 40% of our national exports. Canada's rural natural resources provide employment, forest products, minerals, oil and gas, food, tax revenue, and much of our foreign exchange.
Health care is a service industry, and it requires professional human resources.
The ability to provide health care is very dependent on the ability to recruit and retain highly and broadly skilled professionals. Because of the challenges of isolation, sicker patients, and limited infrastructures, rural communities need the best doctors with a broad range of skills sets. The Society of Rural Physicians of Canada believes it's time to take a step forward and proposes the following human resource solutions—and I believe you have them in front of you.
Rural access scholarships will increase the medical education of rural and remote community residents, who are ten times more likely than urban-based students to choose rural practice. The other solutions are rural access development programs; enhanced training of residents in rural residency; rural medicine skill enhancement programs; expansion of medical schools to the rural communities, to provide training of medical students in rural communities during an entire clinical training period, thereby leading to higher retention of medical graduates in rural communities; rural health research; and a national rural medical round table.
Why do we do this today? Right now, we have to. There is a serious lack of services in rural and remote communities. We can fix this, but it requires political will and leadership. We need a specific rural health strategy that is formulated not by urban-based policy-makers but by rural communities and rural health professionals.
Rural communities need the best-trained doctors, and many more of them. We believe that we—health care professionals, legislators, and policy-makers—all have a responsibility to ensure that all Canadians, whether rural or urban, have reasonable and equitable access to health care. A two-tier health system—a lower tier for rural Canadians and a higher tier with better access for urban Canadians—is not acceptable.
I believe that with your help, we can implement this proposed solution. We have the moral obligation to do so.
Thank you for your time and for your attention, knowing you came in at two o'clock this morning. Dr. Rourke, Dr. Wootton, and I would be pleased to answer any questions.