Industry Committee on Feb. 12th, 2008

[The Chair, Conservative, James Rajotte]

We'll call the 19th meeting of the Standing Committee on Industry, Science and Technology to order.

I apologize for the late start, but the previous committee did have some business to finish prior to our meeting.

We have with us today five associations. We are continuing our study of Canada's service sector. Our witnesses are here for up to two hours.

Our first witness is from the Canadian Association of University Teachers, the executive director, Mr. James Turk. We also have, from the Canadian Chiropractic Association, Richard Gehrke, president, as well as the director of government and interprofessional relations, Mr. John Tucker. From the Canadian Dental Association, we have the president, Mr. Darryl Smith, and the director of corporate and government relations, Mr. Andrew Jones. Here today from the Canadian Healthcare Association is the CEO, Ms. Pamela Fralick, as well as Denise Desautels, the director of policy and communications. Lastly, representing the Réseau des ingénieurs du Québec, we have Mr. Etienne Couture, the president.

We will start with the Canadian Association of University Teachers. I will ask you to keep your opening statements to five minutes maximum. We will go across the table, and then we'll start with questions from members.

Mr. Turk, we'll start with you.

[James Turk, Executive Director, Canadian Association of University Teachers]

Thank you, Chair.

The Canadian Association of University Teachers welcomes this opportunity to present its views to the committee. We represent more than 57,000 academic staff, at more than a hundred universities and colleges in all provinces of the country.

I'm sure you'll all agree that teaching, research, and the community service work that our members perform is critical to the social, cultural, and economic development of Canada. There's virtually no politician in the country—and in this room, I assume—whatever matter their political stripe, who hasn't talked about the importance of post-secondary education for the future of the country. Yet governments all too often ignore the serious challenges faced by post-secondary education.

I want to address three challenges in my presentation today. The first is the crisis in human resources. As you know, many of our members who were hired during the great expansion of the 1960s and 1970s are retiring. Close to 45% of all full-time university teachers are 50 years of age or over. As academic staff retire, they are increasingly being replaced by part-time and contract faculty. At some universities, close to half of the undergraduate courses are taught by non-tenure-track contract faculty. These positions are poorly paid, have few or no benefits, no job security, no academic freedom, and don't even have access to proper offices or support for doing research and scholarship. This has serious implications, not only for the contract academic staff themselves, but also for their students, their full-time colleagues, their institutions, and their communities.

The human resources crisis is intimately linked to the second challenge that I would like to discuss, the ongoing federal underfunding of post-secondary education. Even with the recent increase in the Canada social transfer, federal cash transfers for post-secondary education are still more than $1.2 billion short of what would be needed just to restore funding to the 1992-1993 levels, adjusting for inflation and population growth.

If you feel, as we do, that the federal government should be contributing or investing one-half of 1% of gross domestic product—that is, half a penny for every dollar earned in the country—in post-secondary education, as was done in the late-1970s and early-1980s, then the shortfall is closer to $4 billion.

The impact of underfunding shows up in the human resources crisis, but also in rapidly rising tuition fees and student debt, deteriorating infrastructure, and diminished library holdings, all of which threaten the accessibility and quality of our post-secondary institutions.

The federal government has played the decisive role in funding post-secondary education since the 1950s, when inconsistent and low levels of provincial funding for post-secondary education made it clear there had to be a federal as well as a provincial role. Today, the federal government can and must do more to provide adequate funding to the provinces in an accountable and transparent manner.

The final challenge I want to mention is with regard to research. The federal government has substantially increased research funding in recent years. Much of this, however, has come with an emphasis on applied research that will pay off commercially. The buzzwords have been innovation and commercialization, which, in this lexicon, are synonyms. Basic research, or research whose primary objective is the advancement of knowledge and the understanding of how things work—with no necessary emphasis on practical or commercial gain—is devalued. Yet developments that have proven important and commercially significant typically come from basic research. By devaluing it, we are killing the goose that lays the golden egg.

As Canada's Nobel Laureate, John Polanyi, reminded us several years ago, “When we tie discovery research”—and he was referring to basic research—“ too closely to development, we force our university scientists to run while hobbled in a three-legged race, one leg tied too nearly to industry. This is a mistake we are now making.”

One of Canada's foremost business leaders, Mike Lazaridis, the founder, president, and co-CEO of Research in Motion, put it more pointedly:

I keep hearing that there is something fundamentally wrong with the university research system in Canada. Some very influential people believe that we are not getting the proper “bang for the buck” from our investment in university R&D....

A particularly dangerous version of this thinking holds that professors should patent more.... I have some experience with patenting, and I believe that this is wrong-headed....

Lazaridis continued by saying that the priority should be the funding of basic research:

The number one reason to fund basic research well and with vision is to attract the very best researchers from around the world. Once here, they can prepare Canada’s next generations of graduates, masters, PhDs and post-doctorates, including the finest foreign students. All else flows from this.

A narrow focus on commercialization ignores that the most innovative and valuable research to date normally began with no anticipated commercial outcome, but rather was guided by what knowledgeable scientists thought would be intellectually important to pursue. We encourage the government to increase the amounts of unrestricted grants available through federal granting agencies. This will help protect the integrity and independence of academic research and ensure that proposals are assessed first and foremost on their scholarly merit, the surest way to protect the public interest.

I look forward to answering your questions.

[The Chair, Conservative, James Rajotte]

Thank you very much, Mr. Turk.

We'll now go to Mr. Gehrke, please.

[Richard Gehrke, President, Canadian Chiropractic Association]

I thank you all on behalf of the Canadian Chiropractic Association, which represents our 6,000 members Canada-wide, for this opportunity to offer our rationale and practical application of how we can help decrease cost to the Canadian health sector and reduce patient load on general and family practitioners as well as neuro and orthopedic specialists.

Our distributed document touches on issues challenging our increased utilization and on studies rationalizing our cost-effectiveness and efficiencies at treating neuro-musculoskeletal conditions. Now, that's a bit of a mouthful, but in plain language we speak of back pain, neck pain, and headache. Further detail on any of the materials referenced is certainly available upon request.

I'd like to elaborate on two or three items mentioned in our document, as this may lay the foundation for further discussion.

I'm an Alberta practitioner; thus, I am more familiar with Alberta models of care. The simplest, most straightforward example of chiropractors' cost-efficiencies and treatment effectiveness comes from our Workers' Compensation Board model. In short, chiropractic care gets workers back on the job more quickly and more cost-efficiently than any other health care provider, period. Couple this with the Health Quality Council of Alberta survey last year, which related patient satisfaction to chiropractic care at 90%, second only to pharmacists' services.

Workers' Compensation Board experiences in other provinces emulate the Alberta experience; thus it's a common example across the country.

An example not so common, again from Alberta, is the national spine care initiative, in conjunction with the University of Calgary, which sees a team of chiropractic, physiotherapy, and physiatry triaging for neurosurgeons. Simply put, the quicker back pain—and any health care consideration, for that matter—is diagnosed and directed to the most appropriate health care giver, the better the outcome, be that direction to conservative care, namely chiropractic or physiotherapy or strengthening and work hardening processes, or direction to surgery. It's a matter of the right treatment at the right time for the right reason.

This kind of model, using the low-tech, comparatively low-cost diagnostic skills of chiropractors, is of significant cost-benefit to the system. Chiropractors are highly trained health care providers with the ability to diagnose. Thus, not only are we effective at treating, but we're vastly underutilized at directing traffic.

This is slowly changing, in fairness, and just recently—this past month as a matter of fact—one of our chiropractic researchers with a research chair at Mount Sinai Hospital was indeed given treatment privileges at this hospital, but patients pay personally for those services. That stated, we run into barriers. The Canada Health Act sees that all dollars go to the medical model, and it should be no surprise to anyone around this table that the medical model needs help and not just in terms of more doctors or more dollars. Utilization of a host of low-tech highly skilled health care givers such as nurse practitioners, physiotherapists, physiatrists, psychologists, and chiropractic doctors with diagnostic capabilities could be more fully utilized, to economic and manpower advantage to our health care sector.

Thus, the point we wish to leave with you today, and discuss with you, is that we could decrease cost to Canada's health sector by reducing the physical load on medical colleagues by taking on a sizeable portion of their practices that deal with musculoskeletal conditions, roughly 30% of their workload. Finally, we feel that barriers should be reduced, preferably removed, for those population bases, namely low socio-economic status folks, Department of National Defence members, and first nations people, who find difficulty if not absolute downright impossibility accessing chiropractic care.

I thank you.

[The Chair, Conservative, James Rajotte]

Thank you very much, Mr. Gehrke.

We'll go to Mr. Smith now, please.

[Dr. Darryl Smith, President, Canadian Dental Association]

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.

[The Chair, Conservative, James Rajotte]

Thank you very much, Mr. Smith.

We'll now go to Ms. Fralick, please.

[Pamela Fralick, Chief Executive Officer, Canadian Healthcare Association]

Thank you for inviting me today. I will be speaking in English; however, I can answer questions in French, if you wish.

I would like to start with some numbers regarding the health care system.

In 2006, just over one million people across Canada, or one in ten employed Canadians, worked in the health system. That represents 6% of the total Canadian workforce. Health is one of the major employment industries in Canada.

Of the $160 billion spent on health care, between 60 and 80 cents of every health care dollar in Canada is spent on health human resources. That equates to $96 billion to $128 billion that went towards health human resources.

The health sector is a significant component of the Canadian economy. According to Statistics Canada, the monthly gross domestic product for health services in November 2007 was $67.9 million. That equates to 5.5% of GDP.

That captures health care as a service industry, but if you also include pharmaceutical and medicine manufacturing as well as medical equipment and supplies manufacturing, the amount contributed to the GDP for health services and health manufacturing would increase by an addition $5.2 billion. That's a total of just under 6% of GDP.

Finally, over 100 medical world firsts have occurred in Canada's research hospitals, reflecting, if you will, the entrepreneurial spirit of the medical industry.

A number of health human resources issues are addressed in great detail in the brief you've received from us, but I will focus on a couple of highlights of the highlights, if you will. I know a number of these issues are not unique to the health sector, but we believe they are exacerbated within this setting.

First of all, there's a global shortage of health service providers. The World Health Organization estimates that worldwide, there needs to be a 70% increase in the world's health workforce to address current and projected shortages.

Research suggests that these numbers will only worsen in the coming years, for a variety of reasons, including population aging. I know we've all heard about this in many different contexts.

In terms of aging, in 2005 the average age of individuals in Canadian health occupations was 41.9 years. That's 2.3 years older than the average age of the general Canadian workforce. But to add a little bit of flesh to that particular statement, approximately 38% of the nursing workforce is over 50 years of age and heading towards retirement.

We want to bring a highlight to our aboriginal populations as well. Census data from Statistics Canada have shown that the first nations, Inuit, and Métis populations are growing much faster than the total population. Again, we know this statistic.

We do believe strongly that all levels of government must provide resources to achieve and maintain an appropriate supply mix and distribution of health care providers from these populations as well as to adapt educational curricula for health sector workers to ensure cultural competence of individuals providing health services to this population.

I will briefly mention retention and recruitment issues. In 2006 the unemployment rate for all occupations in Canada was 6.3%. However, the rate for health occupations was 1.2%. In both robust and weak economies, tight labour markets make it difficult, some might say impossible, to recruit the full range of workers required in the health care system.

We also know a lot from the popular press and research about generational and gender issues. I emphasize that health care is a 24/7 industry. I won't repeat here what we all know about the shifts and the needs and expectations between generations, but I can affirm that these differences affect the health system greatly.

Looking at gender as one example, women have constituted 80% of the total health workforce over the last 20 years. So we know that the generations perhaps want to work a little less or a little differently from how some of us have. When you add into this the preponderance of the female population within the health workforce, issues such as maternity leaves, day care needs, and the 24/7 demands of the health system truly do exacerbate the problems of our health system.

I will briefly mention as well research and innovation within our health world. Over 85 spinoff health and medical companies employed more than 2,000 Canadians and generated close to $1.5 billion in investment capital between 1999 and 2006. It's a clear contribution to Canada's economy. We are trying to convert people to seeing health not as a cost but as an investment.

I have a final point, on internationally educated providers. As I mentioned earlier, there is a global shortage of health professionals, and we in Canada, as do other countries, face ethical issues in actively recruiting these internationally educated providers.

It is utterly critical that Canada work towards greater self-sufficiency in achieving an adequate workforce supply within our health system. The Canadian Healthcare Association does not support the aggressive recruitment of health professionals from lesser developed countries, most of which are also facing severe health provider shortages.

In conclusion, I'd like to leave you with three points from these brief overview comments: the health sector is a benefit, not a cost, to the health of Canadians and thus to the Canadian economy; the health service sector is a substantial component of the economy and the labour force; and recruiting, retaining, and maintaining the full scope of Canada's health workforce is vital to assuring Canada's competitive position in the world.

We do not leave you with just these overview comments. You will find approximately two and a half pages of well-defined recommendations in the brief for your consideration. We look forward to continuing this discussion.

Thank you.

[The Chair, Conservative, James Rajotte]

Thank you very much, Ms. Fralick.

We'll now go to Monsieur Couture.

[Etienne Couture, President, Réseau des ingénieurs du Québec]

Mr. Chairman, committee members, good morning. I am pleased to be here with you to study the service sector in Canada. To this end, I will be speaking to you about the engineering field. Thank you for providing this opportunity to express our point of view.

The Réseau des ingénieurs du Québec is a non-profit organization representing 56,000 Quebec engineers. The mission of our organization is to serve the common interests of all engineers in all sectors of activity. To this end, we publicly promote their interests. We provide engineers and engineering students with career-related services as well as commercial benefits.

As part of its mission, the Réseau des ingénieurs du Québec has taken a keen interest in the effects of globalization on the organization of the labour market, particularly on knowledge-based jobs such as engineering. In recent years, we have carried out two specific studies: one on the phenomenon of job offshoring and the second on the situation in the manufacturing sector, with the underlying theme of the impact on the work of engineers.

To gain a good understanding of engineering in Quebec, it is essential to grasp the place of engineering in our society. First of all, more than 30% of engineers work in the industrial sector of manufacturing and production, 20% work in the consulting sector and another 20% work in the public and para-public sector. The work of one engineer generates almost 80 direct jobs. The work of one engineer in the industrial sector generates almost 100 indirect jobs. A large number of jobs in the services sector are attributable to the industrial sector, which remains the true engine of an economy that is balanced, diversified and creates value.

Globalization is an inescapable reality and we must make the best of it. We have to focus on the opportunities it provides. That was confirmed by our study on the impact of offshoring on Quebec engineers conducted in November 2006. Knowledge-based jobs such as those in engineering are no longer immune to international competition and the phenomenon of offshoring. These changes have repercussions for the organization of work, employment, the economy and the social fabric. We can tell you that globalization is transforming the work of engineers. Today, the latter work in a network that includes suppliers and partners located throughout the world. This requires many changes in order to accommodate different time zones and a variety of cultures.

There are a number of factors contributing to the type of changes faced by our industries. We see that you had the opportunity to discuss this before preparing the report Manufacturing: Moving Forward – Rising to the Challenge. In Quebec, we can count on engineering expertise that enjoys exceptional renown. On the international stage, the reputation, competence and effectiveness of Quebec engineers are well known. In terms of economic development and the services sector, it is in our interest to further promote this calling card in discussions with foreign countries.

As regards the opening of markets for our companies, the Réseau des ingénieurs du Québec recommends that Canada concentrate on negotiating free trade agreements with countries where market conditions—particularly in terms of protection of intellectual property, labour standards, social and environmental considerations—are comparable to those prevailing in Canada. The Réseau des ingénieurs du Québec believes that Canada must make it a priority and actively pursue negotiations for a free trade agreement with the European Union. In the past, our businesses could compete with others playing by the same rules. This applies even more so to the services sector.

Commercial trade in Canada must first and foremost be promoted in order to increase trade and to open markets for companies, for services and industries. We believe that there are still too many interprovincial barriers. The study we conducted last October attempts to provide our industrial sector with the tools to face the challenges of globalization. The first conclusion of our study is the need to implement a strong and coherent industrial policy.

This industrial policy must be founded on innovation, investment and productivity. It must be based on solid developmental projects, such as high-speed trains, aluminum processing or the electric car. The first aim of this policy must be to develop sustainable development technologies for industry and services. The time has come for Quebec and Canada to focus on developing its exportable know-how in the area of developing environmental technologies.

To be competitive and to capitalize on the know-how of our Canadian engineers, we must take action and focus on the development of brain power, the main raw material of leading edge, high value added sectors. We must also increase the productivity of our plants and development of our infrastructures, increase investment in research and development and provide for modernization of production.

The Réseau des ingénieurs du Québec recommends that government focus on the research and development diagnostic. Not only would this allow us to identify improvements most conducive to productivity gains, but it would also focus on the development of innovative and durable goods and services. We also urge the various levels of government to rethink innovation programs and include measuring the return on investment in terms of employment and know-how.

In innovation, the involvement of an engineer with expertise in various areas is essential. University and on-going training of engineers and the workforce in general remains a cornerstone of the success of our companies and a priority for the Réseau des ingénieurs du Québec. We need to remember that training our future engineering graduates is an important lever of economic development.

The good news for future graduates is that there is full employment for engineers in Quebec. The unemployment rate for engineers is hovering at 3% compared to 7% for the general population.

[The Chair, Conservative, James Rajotte]

Okay, Monsieur Couture....

Sorry, I thought you were done.

[Etienne Couture]

It is evident that some companies lack the knowledge and expertise to commercialize the results of applied research. The Réseau des ingénieurs du Québec is developing a catalyst to provide this type of support to businesses. To bring these projects to fruition, we need the support of all partners, including the federal government.

As outlined in this short presentation, engineering is much more than a knowledge-based service. It is also an economic engine.

Thank you, Mr. Chair.

[The Chair, Conservative, James Rajotte]

Merci.

Thank you all for your presentations.

We will go now to questions from members. I just want to remind everyone that we have a great number of witnesses here today. Members will have a limited time in which to give questions and receive answers. So I urge you all to be brief.

Members may choose to direct a question to one person. If someone other than the person to whom the question was directed wishes to respond, let me know and I will ensure that everyone gets a chance.

We will begin with Mr. Brison, for six minutes.

[Scott Brison, Liberal, Kings—Hants, NS]

I was very interested in Mr. Couture's comments about interprovincial barriers. It is nevertheless very important for us to respect provincial jurisdictions. This is an important issue but we must respect provincial jurisdictions.

It's not just an issue for engineers. It would be an issue for dentists, other health care providers, and chiropractors. I would appreciate all your advice on what we ought to be doing to deal with the issue of professional mobility between provinces and the issue of foreign-trained professionals.

I know the issues would be different for each profession, so I'd like to hear from each of you. What should we be doing on these two things: the mobility of professionals between provinces, and the recognition of foreign credentials?

[Etienne Couture]

In fact, an important concern in Quebec is this mobility. Obviously the situation varies a great deal from one province to another. Demand may be very high in Alberta and British Columbia, yet there are many engineers in Toronto and not all are able to find employment. It varies according to the region.

Given that it is a provincial jurisdiction, all professional bodies are working on the issue of mobility in each province. The government of Quebec, specifically, has just given its support to the order in its efforts to facilitate recruitment of engineers with foreign credentials. Given that employment in engineering is high, we are looking for this type of initiative and support.

[Dr. Darryl Smith]

Thank you for the question. It's very pertinent to dentistry.

In the late 1990s the profession realized that Canadians wanted health care of the same standard to be delivered across this country. So it didn't matter whether you were in Nova Scotia or British Columbia, there were expectations. As a result, it was important that practitioners had the ability to move across the country.

All the licensing bodies in Canada came together with the profession, and now we have total portability—any professional licensed in any province can move between provinces. That's been a very good thing for the profession.

In the area of foreign-trained individuals, we also realized there was a necessity to make sure the profession had access to people from other places. Working with the universities and regulatory authorities, we have a way to bring people into this country to allow them to practise. Recently we tried to make it even easier for foreign-trained people to come, and we're dealing with foreign-trained specialists right now. It's really an educational issue, to make sure people can come from other places to teach in our institutions, and to allow general practitioners to move. So it's an important area for us.

[The Chair, Conservative, James Rajotte]

Thank you.

Next I have Ms. Fralick, Mr. Turk, and Mr. Tucker, very briefly.

[Pamela Fralick]

I have two points to bring in response to the questions. On the mobility issue and many others, there's no silver bullet. I wish I had one, but there's been quite a bit of work done on developing a mechanism or process to allow those sorts of questions to be answered.

The Canadian Policy Research Network did a paper on just this subject. It has been presented to the advisory committee on health delivery and human resources within Health Canada, and it provides a way forward. So if you have not seen that paper, we'd love to provide you with the link to that or send you the document.

On foreign-trained professionals, congratulations to the federal government for having done considerable work in this area in recent years with physicians and nurses. In the last three years, significant initiatives have been developed with five other professions—occupational therapy, physiotherapy, pharmacy, and medical and lab technology. Right now we need to extend that work to other professions.

[The Chair, Conservative, James Rajotte]

Thank you.

Mr. Turk, please.

[James Turk]

Generally, within the academic world this is not an issue. There is mobility across the country. As you recognized in your question, there are different issues to be balanced here. As this committee heard from the Canadian Bar Association, there is some rationale for some variation by province. I think the model discussed earlier of having the licensing bodies and professional bodies get together to try to sort this out where necessary is the best way to proceed.

I'd like to conclude by seconding something Ms. Fralick said in her presentation. There is a fundamental ethical issue with regard to Canada thinking we can meet our personnel needs by relying on foreign-trained professionals. Most of the countries we're drawing those professionals from are short of adequate numbers of people themselves. So as a strategy, to rely on bringing others to Canada is, in a way, impoverishing the countries from which they come. The goal should be to develop greater self-sufficiency here.

[The Chair, Conservative, James Rajotte]

Sorry, but we're well over time.

Mr. Tucker, do you want to make the point now or wait until later?

[John Tucker, Director, Government and Interprofessional Relations, Canadian Chiropractic Association]

It's not a problem for the Canadian chiropractic profession. We've been in a leadership position in assisting other countries to develop accreditation systems. There is no problem with portability, so we're in a capacity position.

Thank you.

[The Chair, Conservative, James Rajotte]

Thank you, Mr. Brison.

We'll move to Monsieur Vincent, please.

[Robert Vincent, Bloc, Shefford, QC]

Thank you, Mr. Chair.

I find all the points raised interesting but I was very surprised by Ms. Fralick's comments. She stated that, in her opinion, when recruiting people from abroad, we should not recruit individuals from underdeveloped or poor countries. Could you please elaborate on this? If your association, in cooperation with the government, carried out testing to choose persons coming from abroad—without it being in addition to what you already have in the way of training—, perhaps we would have access to more health-care workers and we could therefore fill positions?

[Pamela Fralick]

Could you please clarify your question? I am not sure that I have understood it.