Good morning. Thank you for inviting me to speak to you today on behalf of Canada's 18,000 dentists.
As president of the Canadian Dental Association, I hope to shed some light on the dental manpower situation in Canada, and inform your discussions of the Canadian service sector.
Dentistry is an important, although distinct, part of our Canadian health care fabric. Some $11 billion are spent annually on dental services in Canada, which represents 7% of our total health care spending of a little over $160 billion.
The growth in this sector has occurred fairly steadily, and is well aligned to the growth rate of total health care spending. Over the decades, I can say that the type of care being delivered and the manner in which the care is provided has evolved. Most of us in this room can expect to have our own natural teeth well into our senior years, a relatively new phenomenon, and these advancements can be credited to a number of factors.
We have had the benefit of water fluoridation, better education, and improvements in general health care. In addition, dentistry has moved from the drill-and-fill era of yesterday to a sophisticated and highly effective team-based model of health care delivery led by Canadian dentists. This essentially can be described as a one-stop-shopping model where everything from preventive care to diagnosis to treatment is available under one roof from a team of highly qualified and specialized providers. In many ways it could be used as a model for the evolution of health service delivery throughout Canada.
For the most part, dentistry does not suffer from long waiting lists, provider shortages, or professional burnout. There are many valuable contributors to the dental team, each focused on the area that makes sure of the best use of their training and knowledge—in short, an effective use of limited health care resources.
It's significant to note, I think, that this evolution and successful outcome has occurred in the current context of a partnership system of payment, which exists almost entirely outside the reliance on government dollars. Of the $11.3 billion spent on dental services annually, $10.8 billion is accounted for by private sector spending. Employer-sponsored dental plans have proven a cost-effective means to maintain oral health and a valued benefit to employees. In this respect, the federal government has made an important contribution to oral health by maintaining the non-taxable status of dental plan premiums. We applaud the government's continued and appropriate recognition of the value of maintaining the health of our workforce.
I realize I have probably painted a rosy picture for you, and you may be starting to think that not everything is entirely perfect, and of course you would be right. The trend toward increased private spending on dental care has a negative counterpart, as reduction in government spending in many cases means reductions in care for children, seniors, or the poor. The pendulum has perhaps swung too far, and as a profession we have become increasingly aware of access-to-care issues over the last few years.
Unlike the situation in medicine, access issues in dentistry are not primarily due to shortages of skilled providers, although there are some rural regions in which this is the case. For the most part, the absence of dental plan coverage combined with the inability to pay directly for care leads to a portion of the population missing out on needed services. The dental profession has already reached out to these groups in formal and informal ways, and many dentists quietly provide pro bono services through their office when ability to pay is a barrier to care.
Additionally, the ten dental schools across the country provide community dental clinics where senior dental students provide a wide range of dental services at greatly reduced rates. As a result, in many ways dental students are subsidizing the provision of care through their tuition fees. Tuition fees are the highest of any profession in Canada; this in itself is an issue. We are concerned that the sticker shock associated with the high cost of education may further upset the balance of dentists in rural versus urban areas. As a rural practitioner, this is an issue that is near and dear to my heart.
Another recommendation made by the Canadian Dental Association is that special consideration be given to financing our dental schools, which are really hospitals, on the basis of their unique community outreach that attempts to compensate for reduced public spending elsewhere. However, this issue in itself would warrant another presentation, and I believe I'm approaching the end of my time.
Thank you again for inviting the Canadian Dental Association to testify today. I and my colleague Andrew Jones, who is joining me today as a witness, will be happy to respond to any questions you may have.
Thank you.