SUMMARY
The Health of Canadians: 2017
Friday, January 29th, 2010
EXECUTIVE SUMMARY
For a copy of all of the background documents and powerpoint presentations, please visit
www.carolynbennett.ca. They are located in the “hot issues” section of the website, under the
“Health of Canadians: 2017” link.
Are the 2005 Goals Still Relevant?
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Yes!! But they have limitations...(no focus on limitations of funding; no focus on how we’re
meeting 4 pillars of Canada Health Act; little progress on preventative medicine/behaviour; little
progress on Aboriginal and northern populations)
Though not perfect they remain relevant
Must be focused on CHOICES
Must include all the social determinants of health – poverty, violence, environment, shelter,
equity, education
Which indicators (positive and negative) would serve to motivate Canadians to work as individuals,
families and communities to be as healthy as we can be by 2017?
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Nutrition/Food: salt, fat sugar & processed food in diets, basic nutrition levels, food security,
safer and healthier food products, food insecurity, access to food banks
Addictions: alcohol, tobacco and drug use
Economics: Poverty reduction strategy, fix income disparities, homelessness (affordable
housing), permanent jobs, better working conditions, better employment
Education & Literacy: education & employment of mothers, early childhood education,
childhood education, childcare, access
Mental Health: stress reduction, social conditions on family, work , community, violence &
abuse, spiritual wellbeing
Environment: climate change, environmental degradation (air, water, land, natural resources),
sanitation
Health: reduce risk of chronic diseases, engage youth in physical activity, healthy sexual
attitudes, healthy hygiene practices, injury prevention
Address factors contributing to higher rates of infectious diseases
Address gaps that develop between federal/provincial/municipal health programs
Level of access to safe drinking water
GDP and Social Policy
The 8 factors of democratic engagement (voter turnout; volunteer rate for political activities;
policy impact perceptions; representation of women in parliament; net official development
assistance as percentage of gross national income; ratio of registered eligible voters; satisfaction
with democracy; interest in politics)
Are there other ones we should consider?
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Improve recruitment and retention of HHR
Improve capacity to support health information management and health research
A National Urban Strategy
Build on tracking of belonging and engagement
Promote equity and accountability through global commitments
Prevention is critical and should be followed with intervention
Look at links between learning and literacy in seniors
See life-long learning as social determinant of health
Integrate decisions between different government departments – abandon silo approach
We need the provincial and local levels to develop more specific indicators
Are there targets we could pick right now?
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By 2017 Canada above Japan and Scandinavian countries
By 2017 aboriginals and non-aboriginal Canadians should enjoy the same quality of life
By 2010 all Canadians should have access to safe drinking water
By 2017 all communities across Canada should be empowered and well supported in their
unique needs
Each indicator and timeline should be suited to a target (for example, reduce salt consumption
in 5-10 years, reduce transfats over 2-4 years)
For a copy of all of the background documents and powerpoint presentations, please visit
www.carolynbennett.ca. They are located in the “hot issues” section of the website, under the
“Health of Canadians: 2017” link.
INTRODUCTION/INVOCATION
DR. CAROLYN BENNETT, MP, LIBERAL HEALTH CRITIC
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Welcomed everyone from coast to coast, noted that this was the third virtual consultation we
have conducted (first two were seniors and food)
Goal of day is to make some forward progress on what is most important thing to Canadians –
their health
Health and health care are different and must be sorted out in all ministries, jurisdictions,
sectors
Thanked Women’s College Hospital for teaching the social determinants of health - poverty,
violence, environment, shelter, equity, education
Health Goals roundtable will be grounded in medicine wheel concept and the overarching goal
which is articulated in the theory of the medicine wheel
It is not good enough to patch people up when they’re sick, must keep them well as Tommy
Douglas said
Challenged us to choose aspirational indicators too, positive as well as negative goals
DR. PAULETTE TREMBLAY, CEO, NAHO
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Started with thanksgiving address to show interconnection between all things and to show that
as humans we are connected to everything in our world
Address has ancient roots of over 1000 years dating back to formation of great law of peace –
words still spoken at opening ceremonies to show that world cannot be taken for granted
We must give thanks to align hearts and minds with nature
The medicine wheel is a tool to teach people about population health – people are at the centre
surrounded by the 4 seasons (spring, summer, fall, winter), 4 elements (earth, wind, fire water),
4 races (red, yellow, black, north) – shows we have to hear all perspectives and work together as
one in balance as humankind
Introduced “Regional health Survey Cultural Framework” (see slide 11 of Dr. Tremblay’s
presentation) and “Regional Health Survey Wellness Model”
Priorities for First Nations health include improving recruitment and retention of HHR,
improving capacity to support health information management and health research, reduce risk
of chronic diseases, and address factors contributing to higher rates of infectious diseases
Other key areas include improving infrastructure and housing, improving community health
facilities and strengthening quality of health care services, engaging youth in physical health
activities, and addressing gaps that develop between federal/provincial/municipal health
programs and impact First Nations health
Determinants of community wellness include environment, health status, food security, housing
& infrastructure, community & family, economy & governance, knowledge and learning
HON. MONIQUE BEGIN, VISITING PROFESSOR IN HEALTH ADMINISTRATION, UNIVERSITY OF OTTAWA
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WHO recently released recommendations of the international Commission on the Social
Determinants of Health
- First sentence could not be clearer: Social justice is a matter of life and death
- Inequity in health status within countries and between countries is increasing despite important
health gains
- Gap in health status is widening but poor health not confined to those worst off
- Health and illness follows social gradient: the lower the socioeconomic position, the worse the
health, and the shorter the life expectancy
- Health care “systems” only one determinant of health, but medicine cannot create health
- Important to look at other key social determinants including education, family income, housing,
employment, working conditions, security and the environment
- 1.5 million Canadians lack decent family incomes, safe and affordable housing, suffer food
insecurity and are vulnerable to violence
- Canada manages to mask reality of poverty, social exclusion, discrimination, employment
erosion, mental health and youth suicides
- Canada is one of world’s biggest spenders in health care but one of worst records with respect
to a social safety net
- Offered 3 overarching principles of action:
1) Improve the conditions of daily life – the circumstances in which people are born, grow, live,
work and age
2) Tackle the inequitable distribution of power, money and resources – the structural drivers of
those conditions of daily life – globally, nationally and locally
3) Measure the problem, evaluate action, expand the knowledge base, develop a workforce that is
trained in the social determinants of health, and raise public awareness of the social
determinants of health
DETERMINING THE INDICATORS – OPENING SUGGESTIONS – THE HEALTH GOALS FOR CANADA
SENATOR WILBERT KEON, CHAIR, SENATE SUBCOMMITTEE ON POPULATION HEALTH
“Our children reach their full potential, growing up happy, healthy, confident and secure”
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He endorses the health goals and believes they are achievable
Any health goals process needs to begin with mothers and children
We need to ensure equity here in Canada, especially with our First Nations communities
The provinces are already moving on this, adopting philosophies of respect in Alberta and
Quebec – Ontario is seeking a population health approach which is encouraging
He has written to the Prime Minister and says he has an obligation to improve maternal and
child health
Recognizes the determinants of health as part of the human lifestyle – all must be involved
Communities are disappearing, they must come together to raise children as described in the 1st
goal cutting all jurisdictional barriers and tensions
DR. KIRSTY DUNCAN, MP, LIBERAL PUBLIC HEALTH CRITIC
“The air we breathe, the water we drink, the food we eat, and the places we live, work and play are safe
and healthy – now and for generations to come”
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Must focus on air, food and food products, water, living and working conditions
To choose indicators must understand the state, exposure, effects and action
Climate change is our most pressing issue – severity of heat waves, ozone depletion, skin cancer
With food there is too much exposure to chemicals, concerns about food safety (CFIA has
received a failing grade), resources degraded through contamination
We need a safe and reliable water supply
To fix unsafe housing we must measure for safe working conditions, noise, pesticides and urban
waste
As of 2006, 85% of Canadians live in urban areas – we need a national urban strategy
PEGGY TAILLON, PRESIDENT AND CEO, CANADIAN COUNCIL ON SOCIAL DEVELOPMENT
“Each and every person has dignity, a sense of belonging, and contributes to supportive families,
friendships and diverse communities”
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Despite overwhelming evidence, many of our systems are stuck and unable to translate
knowledge about social chance
There are hoops, mazes and barriers with system silos – they are not built for how we live
We have a ballooning social deficit that’s happening discreetly – most not on margins would say
Canada is doing well
Our society has become too individualistic – we need to come together to build social fabric
Canada is a country of myths – our citizens now see we don’t even have universal health care
In rural Kenya people come together and responsibility is shared across community – here in
Canada we have lost our way
Must start by looking at poverty eradication, we will not make gains if we do not tackle poverty
Must foster a collective “coming together”
DR. IRVING ROOTMAN, ADJUNCT PROFESSOR, EDUCATION AND HUMAN SOCIAL DEVELOPMENT; CHAIR
OF THE HEALTH AND LEARNING KNOWLEDGE CENTRE AT THE UNIVERSITY OF VICTORIA; AND CO-CHAIR
OF THE CHPA PANEL ON HEALTH LITERACY
“We keep learning throughout our lives through formal and informal education, relationships with
others, and the land”
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With the Canadian Council on Learning losing its funding we are in danger of losing much of the
progress made towards reaching this goal
Both formal and informal education are related to health outcomes and therefore still relevant
We must continue the dialogue and build on work adopted in Europe
Starting to look at links between learning and literacy in seniors
Ended with a plea for examining life-long learning as a social determinant of health
SANDRA ZAGON, CO-FOUNDER, CANADIAN COMMUNITY FOR DIALOGUE AND DELIBERATION
“We participate in and influence the decisions that affect our personal and collective health and wellbeing”
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Lots of activity in the past decade to gather data to track progress on “belonging” and
“engagement”
Significant work has been done by Institute of Wellbeing, Canadian Policy Research Networks,
Public Health Agency of Canada, Community Foundations of Canada, Statistics Canada,
Newfoundland and Labrador Statistics, the Council of Europe/OECD and others
Citizen input into ultimate selection is key
Regular validation with citizens is important. What was important to citizens 5 years ago may
not be relevant today
Governments build relationships, trust, shared responsibility and participation opportunities
with citizens, and democratic values are sustained by citizens, government and civil society at a
local, national and global level
Engagement on three levels: individual, government, global (more than participation in
elections)
8 indicators of democratic engagement: Voter turnout; Volunteer rate for political activities;
Policy impact perceptions; Representation of women in Parliament; Net official development
assistance as percentage of gross national income; Ratio of registered to eligible voters;
Satisfaction with democracy; Interest in politics
Challenge is that belonging and engagement are concepts which are not uniformly understood
by researchers, policy makers, indicator experts or citizens – no consensus on definition or
meaning...Data may not exist for matters important to citizens in 2010.
Need to measure disconnect between civil society and government, to monitor democracy and
for change to happen
JANET HATCHER-ROBERTS, EXECUTIVE DIRECTOR, CANADIAN SOCIETY FOR INTERNATIONAL HEALTH
“We work to make the world a healthy place for all people, through leadership, collaboration and
knowledge”
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CSIH is an NGO that promotes health equity globally – injustice in health is inhumane
The world is not healthy and many are dying needlessly
According to Michael Marmot, it is a “toxic combination of poor social policies, bad politics and
unfair economics which are causing health and disease on a grand scale.”
One billion people lack access to health care systems
About 11 million children under the age of 5 die from malnutrition and mostly preventable
diseases each year
Women in Sub Saharan Africa have a 7000 times greater risk of dying in childbirth than a woman
in Canada
The poorest of the poor, around the world, have the worst health.
There is huge inverse between distribution of global distribution of health and world poverty
Indicators include education, maternal mortality, and HIV/AIDS prevalence
Solutions include promoting equity and accountability to the Health Goals through our global
commitments
DR. SUZANNE JACKSON, HEAD, WHO COLLABORATING CENTRE IN HEALTH PROMOTION, DALLA LANA
SCHOOL OF PUBLIC HEALTH, UNIVERSITY OF TORONTO
“Every person receives the support and information they need to make healthy choices”
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(a) Information about healthy living
(b) knowledge about healthy living options + supports
(c) making healthy living choices
Overall indicators: % who know about the “right” choices for healthy living; % who have adopted
healthy living behaviours; % facing barriers to knowledge or behaviour change (no information
or support); Presence of policies, legislation, environmental conditions and other supports
Indicators need to be about knowledge, individual behaviours, and the existence of the supports
to help this happen
Healthy Living Indicators: Healthy Eating; Physical Activity; Healthy Sexual Attitudes; Healthy
Minds and Spirits; No tobacco use; Appropriate alcohol and drug use; Healthy hygiene practices
DR. KUMANAN WILSON, CANADA RESEARCH CHAIR IN PUBLIC HEALTH POLICY, UNIVERSITY OF OTTAWA
“We work to prevent and are prepared to respond to threats to our health and safety through
coordinated efforts across the country and around the world”
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A primary responsibility of government is to protect its citizens from health threats (Safe food,
water, air, transmissible disease)…part of social contract with its citizens and international social
contract
Concepts reflected in International Health Regulations
There are local, provincial and federal responsibilities to make sure IHR (2005) is followed
What should Canada’s health goals be? Develop local surveillance infrastructure; Harmonize
local/provincial surveillance systems; Ensure information flows between governments within
Canada and to governments outside Canada; Develop response capacity at all levels of
government and strategies for governments to assist each other; Help other countries achieve
these objectives
HON. MONIQUE BEGIN, VISITING PROFESSOR IN HEALTH ADMINISTRATION, UNIVERSITY OF OTTAWA
“A strong system for health and social well-being responds to disparities in health status and offers
timely, appropriate care”
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It is the job of the Minister of health to ensure that budgets for public health are increased The
Minister of Health should not take over the Social Determinants of Health – just oversee their
stewardship in all government departments
Canada needs to move up the OECD rankings using indicators such as GDP and social policy
(where we are just above the US, but we should be closer to the Nordic countries)
E-CONSULTATION
Ottawa
Basic Needs:
(1) Are the 2005 Goals still relevant today ?
a. Though not perfect they remain relevant
b. The risk of opening them up for discussion is that it may prove to be an unending task
c. It all starts with our children . It remains critical/vital that this remains clearly stated
d. Prevention is critical. However, prevention should be followed with intervention. We
can’t stop at the identification of the problematic.
e. Aboriginal Communities perspective: these goals are of enormous value. But not until
we start measuring impact can good decisions be made.
(2) What indicators would resonate with Canadians in order to motivate them to work together on
their health, the health of their families and their communities and in the world? & (3) Are there
other ones we should consider?
a. Level of poverty
b. Number of single parent/mother families
c. Level of access to services (Health, Education, Food banks, etc) in a timely manner
d. Level of access to safe drinking water
e. Access to data
f. Gender analysis – disaggregated data
g. Integration between different government departments – Education, Health, Justice,
Public Safety, Environment, etc. These issues should be discussed and tackled
interdepartmentally. No silo approach
h. Amount of money invested in Aboriginal and Non Aboriginal Communities across
Canada
(4) Are there targets we could pick right now?
a. By 2017 Canada be #1 in the world above Japan and the Scandinavian countries
b. By 2017 Aboriginal and Non Aboriginal Canadians should enjoy the same quality of life
c. By 2010 all Canadians should have access to safe drinking water
d. By 2017 all communities across Canada should be empowered and well supported in
their unique needs
Belonging and Engagement:
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Are the goals relevant? Canada is low on worldwide rankings of belonging and engagement
indicators
Macro goal = work to make Canada internally
Extent to which citizens involved: citizen participation; impact of citizens voices on eventual
decisions
Belonging vs. feelings of belonging (factual perception)
Need for consultation (eg. Mental health and perception of belonging to an
organization/association/family)
Indicators of number of organizations that offer value, collaborative relationships
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Canada needs to shine internally through leadership, collaboration and knowledge before it can
aspire to change the world (eg. First Nations, Inuit and Metis without water)
Impact of participation on decision making to qualify and measure influence(must develop a
solid set of indicators)
Need to have indicators measuring both reality and perception (on perception side not just
enough to have high numbers of people belonging to various organization)
Belonging vs. engagement – (card carrying members of an organization but what are their
responsibilities?)
Healthy Living:
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The health goals must be focused on CHOICES
Injury Prevention must be a cornerstone /pillar and be considered as a way to reduce health
costs now and well into the future of any Health Plan.
Indicators should be results-oriented and the importance of structures should be reflected
Prevalence of scope of specific prevention policies (target reduction of transfats, sodium,
subsidies of fruits and vegetables in schools)
Fine-tune measures (coordinate with provinces), collect data with frequency that is conducive
to evaluation and improvement (ie. Measure food intake more than every 30
years...hypertension, smoking, obesity)
We can’t be so reluctant to share expenses (should be in public domain)
Each indicator and timeline suited to target (salt 5-10 years, transfats 2-4 years)
A System for Health:
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Are goals relevant?
First goal – yes
Second goal, mixes social determinants and health care
Divide second goal into two goals:
o Reduce disparities in health status
o Strong system for health that provides integrated, equitable, appropriate care and
service
There are lots of indicators
An example used in other countries to raise awareness: how are you feeling?
We should overlay the indicators. If we overlay then, we can pull indicators and data in
different ways
How to motivate Canadians? Raise public awareness?
Targets are needed
Both a target and a goal: we need a modern surveillance system (the wording I used during my
report back was the accurate phrase of this)
Toronto
Q1 – Are the 2005 goals still relevant?
- Most people around the table stated that the goals were still relevant
- There was a comment that they are very generic.
Q2 – What is missing from goals and what needs emphasis?
- Poverty reduction is missing
- Fairness and equity are important to Canadians
- starting with children is really important
Q3 – What are Indicators or measures of success?
- Need to know trends and have baseline measures
- This can be challenging because we need to measure new things that do not have a baseline.
- Access to Family Practice/Primary Health Care for all Canadians is an indicator
- fairness and equity
- many indicators for several goals are already in the Index of Well-Being (and there are trends linked to
that Index from 1994-2008)
- everyone looking through a health lens is a marker of success
- measures of gender/culture (e.g. males are risky group)
Other Comments
- We should not be afraid to raise taxes
- We need the provincial and local levels to develop more specific indicators
- We need to figure out how to communicate to Canadians about the goals and motivate them
- i.e. Your health care budget will go down if the housing budget goes up.
- Canada is about fair process and good governance & caring for our neighbours
Some notes on Indicators from Other Lunch Discussion Groups Reporting from Across Canada
- Several groups mentioned:
- clean water
- access to primary health care
- housing
- availability & quality of child care
- individual connectedness (# programs engaging citizens)
- level & distribution of poverty
- access to education
Edmonton
What are the most important factors to developing a Happy and Healthy Canada?
Government needs to address the following issues to help create the Healthful Canada we all wish for.
The Government of Canada needs to develop of programs to help combat income disparity and to help
ensure income security for its citizens.
The Government of Canada should develop legislation to ensure the security of Canadians food sources.
It should also develop programs to ensure the enforcement food safety and nutritional regulations.
The Government of Canada should develop programs to ensure the positive development of Childhood
Health in Canada. This includes programs to help diminish Childhood poverty, and sufficient Early
Childhood Learning. Programs would also include the promotion of childhood health i.e Participation,
and Food Guides.
The Government of Canada should ensure the safety and security of all Canadians. This includes
Environmental standards that will ensure access to clean water, air, and physical environments.
The Government of Canada can be involved the promotion of healthy lifestyles and can help to
education Canadians on the importance of an active life and healthy diet.
Southern Vancouver Island
Site Discussion
1. Are the 2005 Goals still relevant?
Yes, however, due to their broad and generic nature they have limitations. Looking more
specifically at the 2004 Health Care Accord principles and priorities there exist limitations to
extent and implementation.
a. No focus on limitations of funding
i. Provinces are spending an average of 40% or more of their budgets on health
care up from ~32% in 2000 (Globe & Mail, Jan 25, 2010, p.A4)
ii. Health care costs have grown from 7% of GDP in 1975 to ~10% in 2007 and
anticipated $183.1 billion in 2009, up 5% over 2008 levels.
b. No focus on how we are meeting the four pillars of the Canada Health Act
c. Little clear progress made on preventative medicine/behaviour
d. Little clear progress made on aboriginal and northern population health improvements
e. No accommodation/anticipation for change:
i. Climate & environment – hurricanes, floods, droughts, fires, food security;
natural resource availability, sustainability; human migration; shifting biomes,
etc.
ii. Economic – global impacts on national issues; changing national economic
realities
iii. Natural disasters – e.g. anticipated major earthquake on Canada’s west coast
f. Little focus on the interdisciplinarity of health; social determinants of health
i. Nutrition – salt, fat, sugar & processed foods in diet, basic nutrition levels, food
security
ii. Clean water
iii. Addictions – alcohol, tobacco, & drug use
iv. Education & literacy – education & employment of mothers, early childhood
education, childcare
v. Physical inactivity
vi. Economics – poverty, income disparity, homelessness (affordable housing),
permanent jobs
vii. Mental health – stress reduction, social conditions of family, work, community,
violence & abuse, spiritual wellbeing
viii. Social health & services – inequities between aboriginal and non-aboriginal,
inequities between women & men, distribution of power, money & resources,
community involvement and community led health improvement initiatives,
transportation, rural accessibility to services, limited number of family doctors
(GPs)
ix. Environment – climate change, environmental degradation (air, water, land,
natural resources), sanitation
x. Government – social policy & governance, reinforcement of primary role of
federal government to provide leadership and basic services, R&D
xi. Private sector – social responsibility, standards of employment practice, R&D &
innovation
g. Problem of Siloing health – need to link health across departments, when other
departments don’t do a good job it results in rising health care costs that must be born
by health-care budget without a capacity of that ministry/department to influence those
costs.
h. Would like to see a stronger emphasis on social and economic equity as being a health
goal.
i. Regarding “A System for Health” goal, this is an appropriate goal, however it is more
difficult to offer appropriate care given the limited number of family GPs (see discussion
of Canadian GPs under item #4 below).
j. Would like to see addition of genetic predispositions to illness
k. There exist barriers to understanding of goals, and how to achieve them, e.g. for
immigrants
l.
Need to have greater emphasis on preventative health otherwise goals are shortsighted.
m. By 2017 Canada & Canadians will face new challenges, different circumstances will exist
than today, information, priorities, strategies, and implementation plans will need to
adjust as circumstances change, e.g., we will need better knowledge of nutrition, food
availability, climate & environmental change
n. Need to have multidisciplinary teams, prevention, and a public health focus – e.g., a
huge % of the budge goes to MD salaries and pharmaceuticals, need greater emphasis
on prevention & public health aspects
o. Concern identified in goal placement with “sense of belonging..and dignity” in what
appears to be 2nd priority to “basic needs”.
2. Other overarching concerns/problems identified.
a. There is an expectation that everything on the market should be available to all people
all the time. This is not practical given the limitation of federal/provincial/tax payer
resources. We need to manage people’s expectations of what is necessary and feasible.
b. Poor distribution of funds versus needs – greatest funding goes to tertiary care, whereas
greatest need is primary care.
Funds
1°
2°
3°
Needs
1°
2°
3°
c. Concern that governments are funding private health-care clinics to build their
businesses with public health-care funding/systems.
d. Suggest there should be recognition at the federal level for where reside (retire) in last 2
years of life given the consume the greatest level of health care services in their last
years, e.g., a program similar to equalization payments.
e. Issues concerning lack of family practioners in Canada (please see below item #4
comment by one of our student participants).
3. Suggested potential indicators & related comments (not prioritized)
a. Availability of multidisciplinary healthcare clinics to all people
b. Individual access to clean water
c. Homelessness & social housing – a priority and is the responsibility of national
government to provide leadership & support
d. Basic food budget for all individuals living on social assistance
e.
f.
g.
h.
i.
j.
k.
l.
m.
n.
o.
p.
q.
r.
Raise what we accept as poverty line
Availability and quality of childcare
Ease, accessibility and awareness of mental health
Income equity & income disparity
% of people who feel connected to community
% of provincial and federal budgets allocated to public health, prevention & health
promotion
% of people who experience high stress
Greater focus on healthy living courses in public education
Level of programming available for marginalized individuals & groups
Level of collaboration between all levels of government to ensure no gaps & overlap
Level of financial & other resource support for local programs serving health & wellness
needs.
Recognition of interrelationship between physical, mental, emotional & spiritual health.
How well are we, at all levels, following the 4 pillars of the Canada Health Act.
Provide health data by sex, location, for aboriginal & other minorities.
s. citizens are willing and able -- i.e. are provided the education and tools -- to take
responsibility for their own health
t. citizens are familiar with a range of alternative medicines and healing modalities
(acupuncture, craniosacral therapy, homeopathy, osteopathy, medical herbalism, e.g.)
u. physicians and nurses are familiar with a variety of alternative medicines and healing
modalities and recommend them to patients to complement their health care
v. allopathic and alternative health practitioners work together for the best health
outcomes of their patients
4. Comment by John Tapping, a participating student, on insufficient medical doctors/GPs
“Canadians subsidize Canadian education for the benefit of creating long-term benefits including
more doctors and professionals; however, we lose much of that investment in doctors when
they leave to work elsewhere such as the U.S. where wages are higher.
With that established we need to realize that doctors are not here in Canada to make the most
money possible. They are here because they like Canada.
We now live in a globalized economy and market place, whereby a doctor has access to many
job opportunities in many cities and countries. We cannot assume that doctors will stay in
Canada because they were educated, born or currently live in Canada.
If Canada wishes to acquire more doctors to meet the growing demand, it must look to attract
new doctors who are graduating from medical school throughout the world. The reason for
focusing on attracting new graduates vs experienced doctors is because an individual, once
established in a location outside of Canada, primarily the U.S., will likely prefer to continue
to remain where they are instead of starting all over again in Canada.
Currently if an international medical professional (from outside of Canada, including U.S.) wishes
to practice in Canada they are required to spend 3 years in a rural area. This is a limitation for
someone with a family who wishes to come back to Canada and practice while being in an area
where their partner can also continue their profession. This 3 year rule also applies to the U.S.
so all international doctors now in the U.S. have already worked in rural areas and often do not
wish to repeat the exercise after having worked their way up to their present standing.
The problem is clearly developed in international medical schools, where the success rate for
Canadians studying medicine overseas to return and practice in Canada is extremely low. In one
current case for which the writer is aware, successful applications of Canadian Students! to
return to Canada is below 10%. Canadian medical students are often discouraged (by other
international medical schools which include Britain, Europe, US, and Caribbean) from applying to
Canada and from choosing to work in Canada because it is generally accepted that it is a waste
of time and effort to apply, and those efforts will most probably or definitely end in a NO.
Canada is now exporting medical school education to the rest of the world, while failing to
accept Canadian Students, who have earned the opportunity to study abroad at International
medical schools, back into our country. If we accept more international students at our
universities, we must understand that it means fewer Canadians studying in Canada, and more
studying abroad at international universities. These Canadians are the most likely people to
return to work in Canada, so we must make Canada the easiest country for them to work in.
If we won't win them with dollars, then we have to win them with accessibility and availability.
This will ensure we benefit from all the effort and investment we put into preparing them for
medical school but failing them at the last step.
Suggestions:
1. Create a program to streamline applications from Canadians who have done their medical
degree at international institutions.
2. Invest in PR and advertising at Canadian universities to educate the current undergraduates
that they will be able to return to Canada after completing an international medical degree.
3. Invest in PR and advertising for international medical institutions to inform Canadians and to
shift the international opinion of Canada towards that of an attractive and accessible job
market.
4. Stop abandoning Canadian students and forcing them out of the country. We lose those
investments and those assets which is a huge waste of money.”
NEXT STEPS
MICHAEL IGNATIEFF, LEADER OF THE OFFICIAL OPPOSITION
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There will be a national brain strategy in the upcoming platform, and other parties should join
the Liberals in advocating for one
Access to treatment must be a condition of citizenship, though we must respect provincial
jurisdictions
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However, there must be a national role in bringing actors who share a belief in the Health Goals
together, and Liberals will be a part of this
In addition to a national brain strategy we must have a national food strategy which sees diet as
a national challenge, and works with farmers, health professionals and producers
With health care costs consuming so much of the national income, we must focus on HEALTH
which will help contain costs
There does not have to be a conflict between education and health
We must respect provincial jurisdictions and facilitate changes with the provinces
We must also invest in prevention and promotion, and work with all sectors