Evidence of meeting #19 for Industry, Science and Technology in the 39th Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was education.
A recording is available from Parliament.
President, Canadian Dental Association
It's a very good question, and I totally agree with my colleague here.
Who we attract to the professions is really important. One of the great things about this country—I know I'm an example—was my ability to access the system...from my parents. I probably would not have been able to go. I would not have been able to afford it.
The real issue for us too is that it really affects what the graduate does after university. I'm an example of a dentist who graduated with minimal debt, and I was able to establish a practice in a very small rural community of 2,000 people in northern Alberta. There was no dentist there. Our problem now is that most of our graduates are forced to go where there are already dentists and work for other dentists as associates.
When you're dealing with access to care, it is critical that our graduates have the ability after graduation to not only have the technical and clinical training necessary to provide services, but as importantly the financial resources to be able to establish or participate in communities that need them. It's not just rural places and inner-city areas. Quite frankly, you graduate with $200,000 worth of debt—I think Andrew will say that's about the average number. The cost of a dental practice is about $500,000, and you need a home. A new graduate is looking at $1 million if he wants to establish a practice. What do they do? They go to Calgary or Toronto.
NDP
Peggy Nash NDP Parkdale—High Park, ON
I represent a riding that has both wealth and poverty. In the poor area, in Parkdale, we have a real problem with accessibility to dental services. I know you talked about the dental schools, but what else can we as parliamentarians push for that will help ensure that people who need dental care and can't get it today will get it?
President, Canadian Dental Association
I think it's an interesting time; it's an interesting debate. We have to look at the social safety net in Canada and make sure those people who are disadvantaged have access to care. It's almost like the interprovincial mobility issue. It really varies across the country. I think we need to sit down with the provinces and make sure that those people who are in need are covered in the Canadian social net. It is a provincial thing. Alberta is probably a leader in care. Newfoundland just announced a children's dental plan for all children under 18.
Conservative
The Chair Conservative James Rajotte
Okay. Thank you.
Thank you, Ms. Nash.
We'll go to Mr. Eyking, please.
Liberal
Mark Eyking Liberal Sydney—Victoria, NS
Thank you, Mr. Chairman.
I thank the guests for coming here today.
Most of you today had presentations representing professions that have a lot of similar challenges. You talked about tuition, availability of your professions in the future, and the challenges you have in the systems you're in, whether it's government, the private sector, or the public sector.
My question is to all of you, or to anybody who can answer it.
Are there European models out there, mostly in the Common Market, that Canada could look at and that would definitely help your profession? Most importantly, are there any that would get Canadians a better bang for their buck, whether it's out of their pocket or through their tax dollars? In your professions, does the European market have systems in place that are a little more advanced or that would have ideas we could use?
President, Réseau des ingénieurs du Québec
I can give you a quick answer.
What we ask for is a mobilization project. In that sense, what we hear from countries such as Norway is that they're going forward with green technologies. This is a statement that we need to hear in Canada. It is something that would mobilize people in a specific direction.
Executive Director, Canadian Association of University Teachers
One of the interesting things among many European countries is the issue of accessibility. A good number of European countries have no tuition fees. Some, in fact, not only have no tuition fees, but actually provide grants to help students with the non-tuition costs of going to university or college.
What's often pointed out when I observe this is that in Canada a smaller proportion go on to post-secondary education. The most interesting example is Finland, where there is no tuition fee, where there is a substantial grant to each student in post-secondary education to help underwrite it—whether it's college or university—and where their participation rate is higher than Canada's. They're simply a society that has decided that their future, economically and socially, is best advanced by a much more significant investment in post-secondary education.
We would be happy to share information with the committee on some of these European approaches to providing greater accessibility.
President, Canadian Dental Association
I don't think it's a European issue. Health care, particularly dentistry, is really a worldwide industry now. Canada has a lot to offer.
I was recently in Dubai. Many of the American universities are partnering with universities, basically taking our expertise and transporting it to another part of the world. In so doing, they are creating economic growth and wealth within our system. I think that's one thing. I know that a number of Canadian universities are also involved, particularly in health care. I think that's a huge area in which we can invest within our university systems. Those university systems will be able to sell not that basic research, but actually the knowledge that other places in this country or throughout this world need.
Chief Executive Officer, Canadian Healthcare Association
I'm contemplating what I can say that would be useful in response to that question. My best response is yes and no. It segues a bit on the comments just made. I should be a politician--sorry.
It's not just the European countries; it is around the world. The “yes” part is that we absolutely have to constantly be looking at the other models of health care, whether it's the educational aspect, treatment, insurance, or any of those pieces, but not just in Europe. There are other countries as well; Australia and New Zealand are the obvious candidates that come forward. The U.S., frankly, we can learn from, but a contextual piece needs to be added to that. What Canadians need and what our context is may not work.
What we see in the U.K., for example, is that the U.K. has had tremendous success with its national health system. Many Canadians and professionals look at it and wonder why we don't have that federal national control, as opposed to the provincial-federal-territorial breakdown, yet they're experiencing difficulties now of various types.
There's no time to go into detail, I know, but we have to constantly stay on top to see what is being offered and what we could perhaps borrow to help address some of our issues within this Canadian context. That's the “no” part of it.
Conservative
The Chair Conservative James Rajotte
You have time for a very brief question, Mr. Eyking, unless someone wants to comment.
Liberal
Mark Eyking Liberal Sydney—Victoria, NS
My question comes back to Mr. Turk. The idea of free education and tuition has been floated around here. Whether or not you're a mine worker in Sudbury and say “Okay, my tax dollars are going to pay for somebody to have free education or tuition to be various professions”, shouldn't there be an onus on the individual to pay Canadian society back, whether or not it is by staying in an area and giving services instead of taking off to Oregon, Tennessee, or someplace? Would that be something you would entertain?
Executive Director, Canadian Association of University Teachers
Before doing this job I spent 15 years working for the trade union movement, with 10 as education director for the Ontario Federation of Labour, so we had a lot of discussions of this, and that point was raised. Interestingly, the trade union movement is one of the strongest in pushing for a significant reduction in tuition, because they see tuition fees as one of the principal barriers that keep working-class kids from going on to post-secondary education.
That said, the overwhelming majority of university and college graduates stay in this country, and the overwhelming majority pay back more than the cost of their education through the higher taxes, as I mentioned earlier, that they pay as a result of the increased earnings they have as a result of their education. In fact, we do have a system for paying for the cost of education. It's called a progressive tax system.
Conservative
The Chair Conservative James Rajotte
Thank you.
Thank you, Mr. Eyking.
I'm going to take the final Conservative spot.
Ms. Fralick, in your presentation you talked about the worldwide shortage with respect to health care professionals. I certainly concur with that.
Can you give us a brief overview of the shortage? For instance, I hear in the Edmonton and the Alberta region that the shortage is certainly far and away in nurses for all types of care. We hear the second-greatest shortage is in family physicians, and then we hear more into the specialities after that.
Can you give us an overview from a Canadian perspective of where the shortages are?
Chief Executive Officer, Canadian Healthcare Association
I would prefer to send you the information and have that at your disposal as you do your deliberations.
At this point, I can reiterate the comment I made earlier that in my experience it is every health profession that is experiencing shortages. It does differ across the country, profession by profession, and there are some charts and tables we can send over.
You hear about physicians and nurses more. They are larger, they are more vocal, and we experience them more frequently.
Conservative
Chief Executive Officer, Canadian Healthcare Association
We'd be pleased to send that along.
Conservative
The Chair Conservative James Rajotte
The second thing, and you may want to send this as well, is in terms of addressing the shortages. The simple-answer solution you hear, which seems to make a lot of sense, is that you need to open more spaces in both nursing and medical schools, so you allow more Canadians to enter. The number I was given anecdotally—I don't know whether it's correct—is that the University of Alberta admitted 150 to their RN program. They had about 2,000 applicants. Is that the solution you're proposing to these shortages?
February 12th, 2008 / 12:55 p.m.
Chief Executive Officer, Canadian Healthcare Association
There are a couple of solutions we need to look at, three that I'll put on the table now, and there may be some other information I can send forward.
One is that we do need to look at maximizing scopes of all health professions. That's been touched on here but not in that language, so we need to make sure all health professionals are doing what they should be doing within their scopes and the full use of that scope. This was touched on a little bit by our chiropractic colleagues. It will lessen the load, whether it's nurses or physicians.
Another point would be advanced practice, which is a growing trend in a number of health professions over the last couple of years. It's quite new. The nurse practitioner is a version of that. There are many health professionals who are able to take on additional duties that would then allow others—to use physicians as the example—to focus on their specialty areas and not have to do the things that others can do.
The third item I'd bring forward is primary health care. The federal government invested a great deal of money, $780 million, into establishing a new way of delivering primary health care through an inter-professional modality. We're dropping that a little bit. The funding ended. There was an expectation that it would simply continue. I think it needs more investment, so I would urge this committee to take a look at that as well.
Conservative
The Chair Conservative James Rajotte
Thank you very much for that; I'm mindful of my own time now.
Mr. Turk, I want to return to the issue of research. You told us that basic research is being devalued in the current political system or the current government.
I've been on this committee for seven years. Perhaps I can review how the federal government actually funds research.
The NSERC budget in 2006 was $914 million. All basic research grants and scholarships do not require matching funds. There is a small program in commercialization. The CIHR budget of $900 million...very famous research by Dr. Ray Rajotte out in Alberta.
Most of the SSHRC budget is geared toward basic research. If you look at CFI, $4 billion is for infrastructure funding; 40% requires 60% matching, usually matched by the provincial government and an institution. If you look at indirect costs of research, that is geared almost explicitly toward basic research. If you look at big science projects, like the synchrotron or the SNO lab, that's geared toward basic research. You have some smaller programs, new networks of centres of excellence and centres of excellence and the commercialization of research.
The criticism of federal government funding research, it seems to me, would be that we don't fund applied research enough. The facts that I have, or that are certainly available, show that the federal government funds basic research a lot more, as a proportion, than it funds applied research.
So I don't understand why you're making the statement you make in your presentation.
Executive Director, Canadian Association of University Teachers
I think I began my presentation on research by indicating that the federal government had significantly increased the funding for research. What I was talking about was the kind of pressure there is to focus research in more applied or more commercially viable areas.
If you look at the presentations of the granting councils to you; if you look at the discussion in the research community; if you go back to four or five years ago, when the Prime Minister's advisory council on science and technology created the expert panel on the commercialization of university research; if you look at the discussions, which I'm sure all of you have been part of, around the concept of innovation, which does not mean innovation as the dictionary would define it but means commercialization, all of that will demonstrate that the climate is very much one of trying to skew things toward what will pay off. And that's understandable, because people want benefits from the research they fund. But the way to skew things is to encourage, informally and formally, more “commercialize-able” ventures.
I guess all I'm saying is that we're not opposed to commercialization. In fact, we benefit from commercialization. It's just that we can't forecast what's going to be done. We're trying to dampen down the pressure to have a commercialization screen applied, whether by the federal government or by granting councils or by universities, which are spending enormous amounts of moneys in technology transfer offices and various other initiatives.
So very much the climate in which we work is where the commercialization side of things is touted. We want to keep reminding...and I'm very happy to hear your words and your view that there is a great value attached to basic research. We certainly think that's justified.
Conservative
The Chair Conservative James Rajotte
But isn't the problem here with the word “commercialization”? Again, if you look at the diabetes example, the Edmonton Protocol, this was a 30-year research undertaking that still continues today. So it's not whether you commercialize the project, it's whether after a 30-year period of research you actually have something where you can take diabetic patients off insulin. That's the goal.
I think the pressure, whether from the federal government, from other agencies, or from Canadians, is that they want to see research that either lengthens or improves their lives, particularly in the medical research area. It's not whether a bunch of money is made, it's whether a patient like Bob can get an islet transplant and walk around and no longer take insulin.
I mean, that's the pressure, and that's a noble goal.
Executive Director, Canadian Association of University Teachers
Yes, and I think there's no disagreement. The question is simply what's the best way to realize that goal?
I would just cite, in concluding, a comment made by Noam Chomsky. He may be known to many of you as a left-wing critic of American foreign policy and also as one of the most respected linguists in the world. He was giving a talk to our counterpart organization in New Zealand a year or two ago. Chomsky said to them: You know, I've spent my entire life at the Massachusetts Institute of Technology, and for most of the 35 years I've been there, the principal source of funding was the U.S. military, through the Pentagon. More recently it's been corporate funding. What I would say is that things have gotten worse as it's gone from the military. My whole life I've been a critic of the military, but the military, the Pentagon, understood that when it undertook funding, it funded basic research and had faith that ideas of use to it would come by trusting scientists to do what they thought was useful. Increasingly nowadays we're getting more demands that the researcher be able to identify realizable goals as a result of the research as a condition of getting funding.
So that's what Chomsky said, and I found it ironic in a certain sense. But I think large sections do understand the value of basic research.