Evidence of meeting #37 for Human Resources, Skills and Social Development and the Status of Persons with Disabilities in the 41st Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was care.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

John Haggie  President, Canadian Medical Association
Nick Busing  President and Chief Executive Officer, Association of Faculties of Medicine of Canada
Michael Brennan  Chief Executive Officer, Canadian Physiotherapy Association
Claudia von Zweck  Executive Director, Canadian Association of Occupational Therapists

3:30 p.m.

Conservative

The Chair Conservative Ed Komarnicki

I call the meeting to order.

As you know, of course, there are bells, so we will suspend after we deal with this motion. Then we'll come back and deal with the presentations. But there are bells ringing, so we'll have to go for the vote.

With respect to the motion, Mr. McColeman, go ahead.

3:30 p.m.

Conservative

Phil McColeman Conservative Brant, ON

I'm happy to present the motion for the committee to consider. The motion reads that the committee examine the main estimates and invite the Minister of Labour and the Minister of Human Resources and Skills Development to appear concurrently on the main estimates, along with departmental officials, during the scheduled meeting of May 30, 2012, from 3:30 to 5:30 p.m.

Just in explanation, I believe we have each minister for one hour of the meeting.

3:30 p.m.

Conservative

The Chair Conservative Ed Komarnicki

Okay.

Do you have a question, Ms. Charlton?

3:30 p.m.

NDP

Chris Charlton NDP Hamilton Mountain, ON

Your motion said “concurrently”. I assume that both of them would be here from 3:30 to 5:30.

3:30 p.m.

Conservative

Phil McColeman Conservative Brant, ON

Yes.

3:30 p.m.

A voice

They will both be here.

3:30 p.m.

Conservative

Phil McColeman Conservative Brant, ON

They will both be here for—

3:30 p.m.

Conservative

The Chair Conservative Ed Komarnicki

Yes, that—

3:30 p.m.

NDP

Chris Charlton NDP Hamilton Mountain, ON

And we can ask questions of either for the two hours, right?

3:30 p.m.

Conservative

Phil McColeman Conservative Brant, ON

Yes.

3:30 p.m.

Conservative

The Chair Conservative Ed Komarnicki

Yes, that seems to be the way the motion is—

3:30 p.m.

NDP

Chris Charlton NDP Hamilton Mountain, ON

Okay. I'm sorry. I thought when you explained it you said one for an hour, one for the other—

3:30 p.m.

Conservative

Phil McColeman Conservative Brant, ON

I'm sorry about that.

3:30 p.m.

NDP

Chris Charlton NDP Hamilton Mountain, ON

Okay.

3:30 p.m.

Conservative

The Chair Conservative Ed Komarnicki

It's two ministers for the two hours concurrently. You can ask questions as you see fit during the two hours. It's pretty much along the lines that you and Mr. Cuzner wish to have it. I don't think we need a lot of discussion on that motion. All those in favour?

(Motion agreed to)

The motion is carried, so we'll expect those arrangements to be made.

I might just indicate to the witnesses that we would have liked to hear from you, but what we will do is suspend until the vote is taken, and then we'll come back, so if you can remain here, we'd appreciate it.

There's another set of witnesses. We'll probably add them to the witness table and have them presenting as well, and then just do one set of questioning back and forth.

Are there any questions flowing from any of that?

Yes?

May 9th, 2012 / 3:30 p.m.

NDP

Chris Charlton NDP Hamilton Mountain, ON

I just think we should point out to the witnesses this new spirit of cooperation they're seeing here between the government and opposition members, because it's rare.

I'm really glad you're here to witness it.

3:30 p.m.

Voices

Oh, oh!

3:30 p.m.

Conservative

The Chair Conservative Ed Komarnicki

Indeed, in some respects, it is somewhat different and novel compared to what has been the case in the past.

3:30 p.m.

Conservative

Kellie Leitch Conservative Simcoe—Grey, ON

It's because of our great chair.

3:30 p.m.

Conservative

The Chair Conservative Ed Komarnicki

That's right.

Is there anything further? If not, we'll suspend for probably about 45 minutes. They're 30-minute bells and the vote will take 10 or 15 minutes.

4:15 p.m.

Conservative

The Chair Conservative Ed Komarnicki

Time is short, the witnesses are here, and we may have more votes, so we'll just get right to it and ask you to present. Then we may have to adjourn again.

We will start with Mr. Haggie with the Canadian Medical Association, and then move to the Association of Faculties of Medicine of Canada.

Please go ahead.

4:15 p.m.

Dr. John Haggie President, Canadian Medical Association

Good afternoon.

Thank you very much for the opportunity to appear before this committee to discuss ways to ensure an adequate supply of physicians in the Canadian health care system.

The reality today is that nearly five million Canadians do not have family physicians, including more than 900,000 here in Ontario. Over one third of all Canadian physicians are over the age of 55. Many will either retire soon or reduce their practice workload.

Many physician practices are at capacity and unable to take on new patients. Canada's supply of new physicians relative to our population is well below the Organisation for Economic Co-operation and Development average. We're the seventh-lowest supplier of physicians per capita amongst OECD nations. Canada ranks below the European Union nations and the United States.

Ensuring Canada has the appropriate number of physicians with the appropriate mix of specialities to meet patients' needs requires planning and leadership at the federal level. Canada must address specific shortages and ensure self-sufficiency in health human resources for this country. Better planning would also help address the issue of wait times and their negative impact on patient care.

The Canadian Medical Association recommends, first, ensuring a needs-based speciality mix; second, targeting health infrastructure investments to optimize the supply of health human resources; and third, addressing the issue of foreign credential recognition.

On our first area of focus, ensuring a needs-based specialty mix, a CMA survey this year of provincial and territorial medical associations on physician resources underscores the pressing need for a pan-Canadian approach to health human resource planning. All jurisdictions in Canada are experiencing challenges, although shortages by type of practice vary from province to province.

Ensuring an appropriate specialty mix requires planning. At present there is no pan-Canadian system to monitor or manage the specialty mix. Our survey found only three jurisdictions that have a long-term physician resource plan in place, while, until today, only one jurisdiction had employed a supply- and needs-based projection model—Nova Scotia just released a second one of these today.

The consequences of this lack of planning are evident. From 1988 to 2010, the number of post-graduate trainee positions in geriatric medicine—care of the elderly—was essentially constant at only 18 physicians, while the number of trainees in pediatric medicine—childhood illnesses—increased by 58%, in clear contradiction to the demographic trends.

The last time the federal government prepared a needs-based projection of physician requirements in Canada was 1975.

The second issue I wish to address is health infrastructure. Recruitment of specialists and subspecialists is affected by the limitations of existing hospital infrastructure, such as operating rooms. Ensuring that infrastructure is in place to allow the doctors that we do have to carry out their work would no doubt help address Canada's persistent problems with wait times.

The CMA recognizes the federal government's commitment to address the issue of foreign credential recognition and recognizes that physicians are in the target group for 2012. The medical profession is well positioned to support the federal government's objective.

Under the auspices of the National Assessment Collaboration—a group of federal, provincial, and other stakeholders—the medical profession is working to streamline the evaluation process for international medical graduates for their licensure in Canada.

The pan-Canadian portable eligibility for licensure is another important issue for physicians. In 2009, the Federation of Medical Regulatory Authorities adopted an agreement on national standards for medical registration in Canada that reflects the revised labour mobility chapter of the Agreement on Internal Trade. The federation and the Medical Council of Canada are working on a one-stop process for IMGs to apply for licensure in Canada.

Close to one-quarter of all physicians in Canada are IMGs. I'm one of them. While the CMA fully supports bringing into practise qualified IMGs already in Canada, actively recruiting doctors from abroad cannot be the only solution to our physician shortage. Canada must strive for greater self-sufficiency in the education and training of physicians.

To conclude, for several years now, the CMA has advocated health care transformation. With the Canadian Nurses Association, it has developed six principles to guide transformation. These principles have been endorsed by over 100 medical, health, and patient organizations.

One of these principles is sustainability. Addressing health human resource shortages is critical to ensuring a sustainable system that's also accessible and patient-centred.

Despite progress, our country continues to experience a persistent shortage of physicians. This is hardly surprising given that few jurisdictions engage in any health human resource planning and that the federal government has not examined physician supply in almost 40 years.

Canada requires a pan-Canadian approach to ensure adequate health human resources in support of a sustainable health care system.

Thank you very much for your attention. I'll be pleased, if the opportunity presents itself, to answer any questions.

Merci beaucoup.

4:20 p.m.

Conservative

The Chair Conservative Ed Komarnicki

Thank you for that presentation.

We have another presentation to hear. I hear the bells going again, so we will need unanimous consent to continue.

Is there a will to hear the next presentation? Do we have unanimous consent? It will take probably seven or eight minutes.

4:20 p.m.

Some hon. members

Agreed.

4:20 p.m.

Conservative

The Chair Conservative Ed Komarnicki

We will hear from the next set of witnesses.

After that, you'll be excused. You can stay if you want to because we'll come back after the next vote, but there won't be a whole lot of time.

So go ahead and present, and we'll suspend after that.