Health committee  I could comment. I'm in favour of midwives because I was delivered by a midwife. But I think it has to be within the context of the skill set. Back when I was a young doctor in Manchester, England, I did 45 home deliveries with midwives. But there was a whole structure built to support that.

Health committee  Okay, I'll start. I think we have to ask ourselves why we have one of the most expensive health systems in the world and we're not performing. We had a Pollara poll done in December 2007 in which 68% of the Canadian public felt that the health system needed a complete overhaul or rebuild.

Health committee  With respect to rural and urban, we have a strategy on that. In British Columbia, for example, and elsewhere, it's been shown that if you have students from rural areas going to medical school, they're more likely to practise in a rural setting. In fact, the data on that in British Columbia is very positive.

Health committee  Well, there are two things. First, there's a lack of comparability of data across the country. Different provinces are measuring things differently. You'll find, for instance, in certain provinces you are not put on a wait list. Even after you've seen a specialist and you've been told you need surgery, there are another two or three steps before you're actually put on the wait list.

Health committee  There are right now, as we speak, 1,500 young Canadians born here, educated here, with undergraduate degrees here who are going to medical school in foreign countries because they can't get a place in Canada. The federal government could have a role in helping repatriate them, because we know from statistics that these students tend not to come back, and we're losing young talent.

Health committee  The doctors, yes, but these students--we know from statistics and surveys among them--do not tend to come back. These are young students who are going to medical school in foreign countries right now.

Health committee  They have 13.

Health committee  There has been some progress with qualifying doctors. We're now up to close to 2,700. But to give you the numbers, in Canada we have seven medical school spots for every 100,000 citizens. Britain, for example, has 13, so we're way, way off from being self-sufficient in the supply of doctors.

Health committee  We need to expand medical schools. There has been some progress in the last few years across the country, but it's not enough. We would like to see us get closer to the British statistic of 13 medical school spots per 100,000 citizens.

Health committee  No, we have seven spots in medical school for every 100,000 citizens.

Health committee  Yes, and the point I've been trying to make in my presentation is that we are spending a lot of money to keep people waiting in Canada. It costs more to have wait lists than not to have wait lists. Research shows that. These people on wait lists are deteriorating while they wait.

Health committee  Thank you. Thank you for having me here today. The CMA appreciates the opportunity to present to the Standing Committee on Health, and I thank you for placing me to the left of Michael McBane. To quote from the accord in 2004: First ministers remain committed to achieving results, recognizing that making health care sustainable and able to adapt to the ever-changing needs of Canadians will take time, sustained commitment, and adequate resources.