Thank you for affording us the opportunity to speak to you today. Dental hygienists are primary oral health care providers, focusing on oral disease prevention and oral health promotion. Oral health has a profound impact on the overall health of Canadians. Periodontal disease, historically considered a localized infection, is now considered a potential risk factor for a number of serious health problems such as cardiovascular and respiratory diseases, diabetes, and low birth weight babies.
The links between oral health and general health underscore the need for a health system that integrates the mouth with the rest of the body. Two human resource system changes can support this integration. Number one, dental hygienists must be able to work with other general health professionals and to work unsupervised to increase access to care. Adequate access must be provided to post-secondary and continuing education.
What does the federal government need to do to support the oral health human resources system? First, it must remove barriers to accessing dental hygiene preventive services. What is the largest roadblock? Dental hygienists are not paid directly for their services. In many provinces and territories, in order for dental hygienists to be paid for their services, they must work for a dentist. This creates a monopoly on oral health services that does not benefit the public in the end. The public service dental care plan and the Veterans Affairs Canada--VAC--dental services program perpetuate and support the monopoly by not paying dental hygienists for their services. Several international reports and letters call for payments directly to dental hygienists in private businesses. The spinoff from the direct payment will be increased competition and increased access to oral health services. A letter from the Canadian Competition Bureau overwhelmingly supports the ability of dental hygienists to initiate practice with no restrictions from dentists.
Recently, the U.S. Department of Justice and Federal Trade Commission published a report on competition in health services that documents how dentists' control over dental hygienists reduces competition in oral health services. In addition, the OECD recently published a report on competition that highlights the negative impact of dentists' attempts to prevent independent dental hygiene practices. The competition authority in Ireland also criticized the dentists' efforts to forestall independent dental hygiene practices.
Two government dental plans--the pensioners' dental services plan of the federal public service and the Ontario children in need of treatment, CINOT, dental program in Ontario--pay dental hygienists directly for their services. The federal government must follow the lead of these progressive programs. This will allow competition to flourish and improve access to oral health services.
Second, the federal government needs to strengthen human capital. Strengthening human capital through continuing education is of paramount importance to the dental hygiene profession, and it is a requirement for licensure in most provinces. Continuing education ensures health professionals keep abreast of constantly changing research, education, and technology. It ensures quality standards, programs, and services--quality that so many Canadians have come to depend on--and ensures excellence within the profession, accountability to the public, and increased productivity.
The federal government can encourage health professionals to participate in continuing education through income tax incentives. We call on the federal government to expand several definitions in the Income Tax Act to enable health professionals to obtain deductions for a broader range of continuing education activities, including conferences and online courses. The definitions in the Income Tax Act that require revision include the following: designated educational institution, certified educational institution, and qualifying education program. Definition revisions should allow individuals to claim expenses related to continuing education events. Income tax deductions for an expanded number of continuing education activities would provide an additional incentive to Canadians to increase their knowledge and skills. It would result in investment in lifelong learning and it would increase productivity.
Human capital can also be strengthened by improving access to post-secondary education through improved student loans. Dental hygienists are educated during two- to four-year programs of study at a college or university. Many students are battling the high cost of this education, which can cost up to $40,000. The elimination of grant programs in most provinces puts a further strain on students.
In conclusion, you can make critical changes to government policies to improve oral heath human resources in Canada and the oral health of Canadians. Support the direct payment of dental hygienists, improve access to post-secondary education and continuing education through tax incentives, and improve financial assistance for post-secondary education.
Thank you. We will be pleased to answer any of your questions.