Industry Committee on Feb. 12th, 2008

[Colin Carrie, Conservative, Oshawa, ON]

You hear about doctor shortages, but I personally see it more as a service shortage. As I think Dr. Gehrke said, 30% of medical doctors are doing the musculoskeletal work. If chiropractors, physios, or OTs could be doing that, and there are barriers to care due to government policy or regulations, then that's something I'd be very interested in debating to see if we could address that.

On this service shortage or doctor shortage, if we properly utilized the professionals who are out there—psychologists, dietitians—and we kind of levelled that playing field, maybe that is something the federal government could take leadership on.

I would like to hear your comments on that.

[Pamela Fralick]

If I may, while I'm sure the chair won't allow us to have the full debate that we might enjoy on that--we understand that this is preliminary—we'd love to come back.

[The Chair, Conservative, James Rajotte]

Right now you have 30 seconds.

[Voices]

Oh, oh!

[Pamela Fralick]

Certainly you do hear a great deal about physician and nursing shortages. These are our largest health provider groups. Who among us would not want to have their physician or their nurse at a time of need? So that's a natural issue to hear about.

From a Healthcare Association perspective, I'd like to support what you said. It really is about the mix, and the need is at all health provider levels.

I also, by the way, chair a group called HEAL, Health Action Lobby, which you might have heard about. It represents 36 national health associations and organizations. When we go around the table, no one says, “Gosh, we have so many health providers, we don't need any more.” So it is across the board an issue, and needs to be looked at.

Earlier I mentioned this paper that's describing a mechanism that can get governments, at all levels that are necessary, to have that debate together and make sure we do act appropriately in addressing the issue.

[The Chair, Conservative, James Rajotte]

Thank you.

Thank you, Mr. Carrie.

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

[Peggy Nash, NDP, Parkdale—High Park, ON]

Thank you, Mr. Chair.

Welcome to all of the witnesses. I was thinking, as you were making your presentations, that you represent the professions that so many parents aspire that their kids will get into. It's great having you all here in one room.

I do have to say, since we have some health care representation, that I just went through quite an intense experience with a family member in the health care system. I tell you, after a long hospital stay, access to some of the best physicians on the continent, and a very successful outcome, I have nothing but singing praises for our health care system--and we didn't have to produce a credit card at the end of it. It was a very successful experience, thank goodness.

A couple of you raised specifically issues around demographic changes or generational changes in your professions. I'm sure all of you are facing that.

Mr. Turk, you raised an issue about perhaps a deteriorating quality in the kinds of jobs that are resulting.

I'd like to ask each of you, what are the challenges you're facing with that generational change, and what are the strategies you have in place in your professions to meet the demands, not just for today but for the future?

[The Chair, Conservative, James Rajotte]

Go ahead, Mr. Turk.

[James Turk]

Before I begin, I will just point out that I grew up in a family in which my father was an engineer, and he was gravely disappointed that I let down the family by becoming a professor.

In any case, the challenge I described in the presentation is a very serious one. A study done at Carleton University several years ago, for example, showed that more than half of all undergraduate courses at that time were being taught by non-tenured people on contract, with low pay and so forth. That's largely a result not of some desire of university administrations to emulate the model of the Hudson Bay Company or other retail sectors, in which the majority, if not the overwhelming majority, of employees are part-time; rather, it's a response to underfunding.

With university budgets not able to meet the growing need in terms of growing enrolment and the need for more sophisticated lab equipment and larger library collections, the way they're coping is with a human resources policy that relies less and less on full-time faculty. And the consequences are quite grave.

The solution we see to this is to lobby aggressively with all of you for more adequate funding, as I mentioned in the presentation. We think that going to the standard of one-half of one penny for every dollar generated by the Canadian economy as a worthwhile goal for the funding of post-secondary education by the federal government is a key part of the answer to that.

[Peggy Nash, NDP, Parkdale—High Park, ON]

Thank you.

[Richard Gehrke]

If I understand your question correctly, internally we have issues in terms of gender demographics. We have more ladies becoming chiropractors. We don't really, quite frankly, suffer any inequity in not having enough chiropractors right now.

If I can just take that and lead into what you may be referring to as well, we do have an issue or a consideration in terms of the ageing demographic.

[Peggy Nash, NDP, Parkdale—High Park, ON]

Yes, that's my question.

[Richard Gehrke]

As a matter of fact, our profession has just completed a program that's called Best Foot Forward, and it's a falls prevention program that we are about to release nationally, as a matter of fact this very month. It's a wonderful program that deals with the issues of seniors ageing, living in their own homes--the kinds of issues one would--

[Peggy Nash, NDP, Parkdale—High Park, ON]

May I just ask you, though, in terms of the ageing demographic within your profession, whether you are finding that there is a baby boom generation about to retire among chiropractors and that you have a new generation of young chiropractors coming in? Is that the reality or not, and if so, are there any challenges your profession faces?

[Richard Gehrke]

It's a reality, and I don't see any challenges that face our profession.

[Peggy Nash, NDP, Parkdale—High Park, ON]

Thank you.

[Dr. Darryl Smith]

There are so many things one could go on about, based on your question, but I want to put it in context in terms of education, because I think it's really a key issue.

In dentistry, there have been no new dental schools in Canada for 30 years, and there are actually fewer dentists graduating now than did in the eighties. So we have a manpower situation that could potentially be critical, probably in the next 10 to 15 years, because of that.

The other issue, though, is the funding of dental education.

[Peggy Nash, NDP, Parkdale—High Park, ON]

Can you tell us what the tuition is for a dental student?

[Dr. Darryl Smith]

I can't give you the exact tuition, but at UBC, for example, it is $50,000 per year, and it's divided into two components. So if you're in a four to five-year program, you have, potentially, a $200,000 to $250,000 debt just for your tuition, not for living costs or whatever. So I think that's absolutely critical.

The component I want to talk about, though, is divided into two issues: one is tuition, and one is the cost of the dental hospital within the facility. I mentioned it in my brief. That can represent $25,000 or more, and the student is actually paying for the facility. If you were a medical student, you would go into a publicly funded hospital. In dentistry, the students and the university pay for a facility to graduate future clinicians. I think that's something we have to look at.

[Peggy Nash, NDP, Parkdale—High Park, ON]

Thank you.

[Pamela Fralick]

I would like to make one comment. I speak not on behalf of any one provider group, as you know, but rather on the health care system as a whole.

We haven't done a good job in this country of doing needs-based planning. We've done supply-based planning. So we have determined the number, the mix, and the distribution of health care providers based on how many we can supply, basically.

We haven't looked enough at exactly the point you're raising: the demographics of the country and what will be needed. How does this ageing population translate into needs for specific types of health providers? You then map that back to our educational programs to make sure we have the right mix.

We have been getting there within the last year or two, but that's an area on which we need to focus.

[The Chair, Conservative, James Rajotte]

Thank you, Ms. Nash.

Mr. Simard, please.

[Raymond Simard, Liberal, Saint Boniface, MB]

Thank you, Mr. Chair.

Mr. Turk, I've heard from other teachers that research is now focused on projects with commercial possibilities. I'm wondering how this happens. A teacher would apply to CIHR, for instance, for a grant. Is the process biased towards research that could be commercialized? Could you still apply if your research has no commercial possibilities?

[James Turk]

The answer is a complicated one. There are some programs that require a co-funder, which is usually a private sector partner. In effect, this partner has veto power over whether the project gets public money. In other cases, the granting councils themselves, sensitive to the fact that the federal government is putting great emphasis on commercialization, give their programs more of a commercial orientation, believing this to be the best way to encourage the federal government to provide the kind of funding we desperately need in this country.

So some programs require commercial linkages. More informally, a certain pressure guides people to favour projects that may have a commercial bottom line. The difficulty, however, is that our ability to predict commercial success in research is abysmal.

Paul Berg, who got the Nobel prize at Stanford for his research on the splicing of DNA, which arguably helps underwrite the entire biotech industry today, said that if he had had to pass through a commercialization screen to get this money, he wouldn't have gotten a dime. Yet his work now helps to underwrite a multi-billion-dollar industry. If you talk to most scientists, whether it be in physics or biology or chemistry, they'll point out that the most important commercial developments in their field have by and large come from basic research.

So we shouldn't dismiss commercialization, but we should remember that we can't forecast what's going to be of value. We really need to trust good scientists to identify good science. That's what Mike Lazarides and John Polanyi are both saying.

[Raymond Simard, Liberal, Saint Boniface, MB]

Thank you.

Mr. Couture, do you anticipate a shortage of engineers in Quebec in the near future? Are there enough engineers in Quebec?

We have also spoken about interprovincial barriers. I believe that almost all witnesses that appeared before us have mentioned this. All provincial premiers say that they wish to resolve this problem but there always seems to be resistance. I know something about that because I was a member of a federal team working with the provinces. Even though the federal and provincial provinces are willing, there is a certain resistance to the idea.

Is the source of this resistance the protectionist reflex of the provinces or of the associations that issue licences to the various professions?