18 Comments

The following is a sample of doctors/1000 population: UK - 5.8, Norway - 4.9, Finland - 4.6, Sweden - 4.3, Australia - 3.8 and Canada - 2.4 (Source WHO). Why is it than so many keep avoiding this real issue. We have a growing population (500,000 immigrant a year for example) and a medical profession that seems to be relatively shrinking. Fix this and problems like no family doctor, wait times and doctor burnout will melt away.

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Apparently in order to have more entrants to medical school we need more residency positions. Hopefully with any new funding this will be a consideration.

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There are thousands of Canadian young people who have been educated and trained in other countries. My daughter was one of 85 Canadians in her year of med school in Brisbane Australia in 2009. It's only one of many schools in Australia and other places. What a great potential source for repatriation and no need for residency.

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I could think of reasons to go to med school in Brisbane, but I’m curious what her reasons were.

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In December, Greg Mercer had two articles in the Globe and Mail that outlined much of why there are so many Canadians going abroad for medical school. They are worth the read, and I cannot say things better than he did. Many, including my daughter, have finished training (aka residency) as well as schooling and therefore do not require residency spaces, just an acceptance of their credentials without high application expenses and a writing of the exit exams that the have already done.

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Thanks, I’ll look out for the articles.

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Well I agree with your last remark, Trudeau is not much of a manager, more a master of ceremonies and good at dancing around. Morneau has a point in his book about JT.

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I'm a great fan of CIHI, both in terms of their substantive work and their responsiveness to the public. I would not have been able to do my analysis of birth tourism in Canada without their information and their advice in terms of what data was available and what was most relevant to my research questions. The data side of government generally much better than the ATIP side given Open Data and the people in departments behind it who are helpful.

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I am enjoying how you join the dots on this, although you are much too benevolent. "Elegant" hardly describes how this gang mangles the facts in pursuit of the next political cycle.

Poor old Duclos. Perhaps he will go the way of Morneau. Has the right "profile" for a Health Minister, so lets put him up there. Meanwhile - the PMO can get on with the business of doing his job for him...

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Went to the passport office yesterday to renew mine. Face masks everywhere, I slipped mine below my nose so my glasses wouldn't fog up while filling out forms and was promptly told by a roving security guard to put my mask on. Only in federal offices does this exist, why ?

The clerk asked me do you want to pick up your passport or have it mailed to you. I said I would come and pick it up personally, he said there was a $20 pick up fee. I said how much to have it mailed, he replied its free. Only the federal government would charge for something that costs them nothing and not charge for something that costs them, again why ?

I inquired why a 10 year passport was more expensive than a 5 year one, given that they are overworked and logically they should encourage 10 year passports to lessen the demand. No response, again why does the federal government do everything backwards ?

So now I come to health care, can anyone take the federal government seriously when they want to require a plan from the provinces before increasing funding ? Its not like the average age is going down and costs diminishing, anyone with a grade 4 education can figure that out.

The Toronto Star ran an editorial recently demanding that health care be centralized in Ottawa, really ?

The feds can't ensure defense procurement, manage the RCMP, deliver passports, etc etc yet there are voices out there that sincerely believe they ( the feds) should take on more responsibilities.. They have foisted a 500,000 p.a. immigration quota on cities which all have major housing problems , again why ? To curry votes ?

I am aghast.

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Nowadays I find that it's just darn near impossible to find out who is the Executive of anything....from parking by-laws to the PMO....that's just not going to work forever...something will break at some point and then....

...we seem to be staring at it on health care now, tomorrow Trade and infrastructure?

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I have never clicked on anything in Facebook before, but this morning I saw something sponsored by Oxfam, which was "send a letter to Freeland calling for a wealth tax". Like the Brexit bus, it had this huge figure of added income ($20B?) which would notionally all be applied to health care, and save the day.

For some reason, I clicked my way through, gave my email and phone, the works. No doubt I have sentenced myself to Oxfam spam and phone calls, but it came after reading yesterday about the incomprehensible sums added to the wealth of the very rich, during the pandemic...while the poors did the essential services and took the casualties.

I was just so pissed - and the very, very obvious conclusion, as Mr. Stewart notes about the doctors/1000 figures, is that we have to have more permanent spending, need taxes for that, can only turn, like Willie Sutton, to where all the money is.

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Hi Paul, not really a problem, but I believe that both your links go to the Government of Canada website.

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Excellent catch. I've fixed the CIHI link. Thanks.

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Under the Canadian Health Act the Provinces and Territories have primary jurisdiction on how funds are allocated and spent. Historically these successive governments have horribly mismanaged their affairs and this was amply proven by the pandemic. The first indication of mismanagement was in eldercare followed by inadequate staffing in emergency rooms which required surgical teams to be transferred to acute Covid care. During the decades of many governmental stripes, health care funds provided under the Act from the Federal Government were used for other purposes than health care. Inadequate education of doctors and nurses plus the negligence of modernizing and building more hospitals and regulating senior homes were the result. Still the Premiers at every opportunity begged the Feds for more money and made it clear that these funds would have no performative strings attached. Now the universally despised Trudeau, after sending billions for Covid relief to mitigate its effects has waited them out. No matter what this time around the Federal Government will attach specific health outcomes to provinces for the money. At long last there will be accountability in the junior jurisdictions for health care. If as a result provinces can't steal the health care dollars for roads, insurance bailouts or disaster mitigation then they will have to levy taxes to pay for these.

I have reason to believe that provincial taxpayers may begin to hold their provincial governments accountable as no longer will the Federal government be blamed for the chicanery of the Premiers.

We will see how this shakes out in a week or two and in the months that follow as provincial health ministers will need to contend with a fundamental change in how they operate their portfolios.

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Historically the Federal government has horribly mismanaged its affairs , this is evident to all ( Passports, defense procurement, RCMP, etc. etc.) . When you state that provincial governments are ''stealing '' health care dollars you forget that health care now makes up 50 % of provincial government spending and all Canadians pay federal income tax and GST.

Your conclusion that requiring specific outcomes by the Feds will somehow improve the system is wishful thinking at best.

What lessons can the Feds possibly give to the provinces on improving their delivery of health care is beyond me when they can't even manage those jurisdictions for which they are constitutionally responsible.

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Nice piece Paul ... have been tweeting about this CHT theatre since early January. Pan-Canadian Health Data is long overdue and you hit the bullseye on Minister Duclos, a steady hand at Tunney's Pasture who is not prone to partisanship or games, such a refreshing change after Ministers Philpott, Petitipas Taylor, and Hajdu who were talking point masters, but not effective Ministers.

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I disagree with your comments. Having said this, in the good Canadian spirit of equanimity, if such still exists, please outline your solutions, Do they square with those of the Conservatives now led by M, Poilievre?

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