Thank you, Mr. Chairman and honourable members of the committee.
The Ontario Association of Nuclear Medicine is glad to present the views of the physicians who oversee the approximately 100 departments and clinics that offer the services of nuclear medicine across the province of Ontario. Half of these, approximately, are hospital-based facilities and half are in clinics or independent health facilities dispersed widely throughout the province.
There are significant challenges related to that geographic dispersal of resources in nuclear medicine in Ontario. That has been challenged over the past decade by little change in the technical fees reimbursed for procedures done in both clinics and hospitals. As a result, nuclear medicine, which has been in a situation of financial restraint over the past year, has found itself in a fragile financial situation. This crisis has tipped us over into a period in which it is extremely challenging for our physicians to deliver health care to the patients of Ontario.
Most clinics and hospitals have worked in situations of barely breaking even, or, currently, of operating at significant losses due to the unique situation of reimbursement in Ontario relative to the rest of the country. As a result, equipment and software that could assist us in addressing some of the concerns brought to our practices on a daily basis cannot be responded to.
We see a silver lining in this crisis, in that by working with our physicist colleagues and with developments in the science of nuclear medicine, the ability to do more with less has been presented to us. As Dr. Urbain has said, there are new technologies available, both in the detectors used in nuclear medicine and in software, that use the activity from a patient more efficiently to reconstruct the information derived from a patient, at a significantly lower dose to the patient and in a shorter time, which would allow a greater number of patients to be done on newer technology units. Unfortunately, the ability of hospitals and clinics in Ontario to acquire these technologies has been limited by financial constraints that are directly due to the increase in costs leading from the isotope shortage.
We concur with the Canadian Association of Nuclear Medicine on several of the points that have been brought forward.
We feel that there is a need for the development of a nuclear medicine fund to address the one-time and long-term funding issues we face in the wake of this shortage. This fund could assist hospitals and clinics across this country, and particularly in Ontario, which has been more significantly affected, in addressing the hardware and software shortfalls we're experiencing. Investment in these technologies could assist us in taking care of patients within the reduced activity situations we are weekly and monthly dealing with.
Additionally, we see PET, and particularly with the geography of Canada and Ontario, mobile PET, as a solution, both in the short term and in the long term, that will assist us in dealing with periodic and long-term shortages related to the isotope crisis.
The development and funding of regional radiopharmacies to assist us in more efficient distribution is something we would seek urgently to address.
Until the situation this spring, we had relative ease of distribution of the technetium supply given to us. Now the necessity of concentrating activity within geographic areas to allow us to distribute more efficiently is critical to further the delivery of health care services in Ontario.
We ask that we address the instability in supply, both in the delivery of services of isotope and in its distribution, so that we can count on a stable supply within institutions for planning of patient scheduling.
We also caution, as the Canadian Association of Nuclear Medicine has stated, with respect to having a stable alternative as we move forward. We are concerned about the implementation of experimental technologies prematurely, before we are sure that we are not going to result in a situation similar to what has occurred where technologies are not able to be deployed.
We also ask for an independent review, an international review, of the status of the MAPLEs, and to revisit whether this decision is sound and could be addressed to assist us in the short term and medium term.
The past six months have been extremely difficult for physicians across Ontario in delivering health care to their patients. I think communication has been an issue within this crisis as well. We ask that we all work together to assist physicians on the ground in communicating and planning so that when disruptions in delivery occur, we're able to address them in a timely manner and minimize the amount of disruption to patient services.
Thank you.