Health committee  I'll start with the licensure issue first. With regard to access to care, we know that one of the things that's really challenging right now too is also streamlined access to specialist care. That also impacts primary care providers as well, because a major source of burnout for family doctors is being unable to get their patients the care they need in a timely manner.

Health committee  I think we definitely find ourselves in a challenge now as to how we try to leverage some of these ideas, which are pan-Canadian issues, and to get some momentum on solving issues that impact everyone, as opposed to continuing to be completely siloed with the current 13, arguably 14, health care systems that we have.

Health committee  I think it's really important that we try to bring the health care professionals who are already in Canada into our system, We know there are many examples of physicians, nurses and other health care providers who are already here in Canada, who have really struggled to access the system for multiple reasons.

Health committee  That's an important question. Our vision for it is not that; it's that it would be a seamless process with all of the provinces and territories participating. You might want to think of it as one-stop shopping, so to speak, if those agreements were in place. The goal is not to increase the burden on physicians in pursuing their licence, rather to streamline it and recognize that the requirements are essentially the same now.

Health committee  Thank you for the question. It's a difficult one, because there are clearly so many issues. From my perspective, probably the biggest crisis in front of us where there are some options, but what we could work on, is the crisis in primary care. When that part of the system is not working, it directly leads into the overload we're seeing on secondary care systems like emergency departments and specialist access, etc.

Health committee  Thank you. I am Dr. Katharine Smart, president of the Canadian Medical Association and a pediatrician based in Yukon. I'm speaking to you today from the traditional territory of the Kwanlin Dün first nation and the Ta'an Kwäch'än Council. Thank you for this opportunity to address, once again, the growing health human resource emergency.

Human Resources committee  There are definitely opportunities for Canada to grow its economy in terms of things like providing PPE. Also, vaccine production, I think, is going to be critical. If we're learning anything from COVID, it's that the playing field keeps changing. There's still lots of innovation coming with vaccines.

Human Resources committee  I can start. Thank you, Chair, for the question. I certainly agree, and the Canadian Medical Association agrees, that we have both issues at hand. There's no question that there are many structural issues within the health care system, including outdated payment models, outdated structural models and outdated ways of trying to provide primary care in a traditional, siloed, fee-for-service model.

Human Resources committee  I'll also comment. From our perspective, in terms of innovative ideas, we've mentioned some of them today, such as national licensure and opportunities to create more mobility within the health workforce. They also create a lot more opportunities to scale and consider virtual care, and how it can be used to address access issues, particularly with things like rural and remote patients being able access specialist care.

Human Resources committee  I think right now where we find ourselves is feeling that people are listening and hearing our concerns. We certainly appreciate the opportunity to present to you today and at other parliamentary committees, as well as in other contexts. I think the concern and the challenge you're hearing from all of us is how we can move from laying these problems out to the actions and solutions to solve them.

Human Resources committee  I think in the past there have been some limitations at the government level in restricting billing numbers for physicians in order to try to direct the health workforce into certain locations. To my knowledge, I don't believe that we see the provincial and territorial medical associations at all limiting numbers of training spots, either at medical school or at the post-graduate level.

Human Resources committee  I can also comment. We certainly support and recognize that there's a need for the Canadian health care transfer dollars to increase as well, and that predictability and sustainability of funding is important. However, we do also support the idea of targeted funding for the reasons I mentioned earlier, which is to improve collaboration at the federal-provincial levels to allow us to scale up things that are working in certain parts of the country into other parts of the country, and to create accountability for where those dollars are going, to make sure that they're actually achieving the outcomes that Canadians want to see in the system.

Human Resources committee  I think what we see is that there are certain areas right now within the health system that are particularly in crisis. We believe that targeted investments to ensure that funds go to supporting those areas have more opportunity to create accountability in the system and outcomes for Canadians versus large sums of money being absorbed into a general budget.

Human Resources committee  The things that need to be replaced vary across the country and across communities, for sure. We see that with diagnostic imaging equipment, with surgical equipment and, really, hospital equipment. I think you're going to see that different jurisdictions have different challenges.

Human Resources committee  I don't think we've seen a really significant impact that way amongst physicians. Over 99% of physicians are fully vaccinated against COVID-19 across the country. Certainly, we've heard a case here or there, but I don't think we've seen a substantial impact on the workplace. I think we have seen other impacts, of course, from the pandemic.