Mr. P. B. Rynard (Simcoe North):

Mr. Speaker, on June 8 1 asked the Minister of National Health and Welfare (Miss Begin), in view of the loss of almost 4,000 doctors from Canada during the years 1967 to 1977 and with increasing losses possible for the future, what plans she had to rectify the situation so that she could assure the Canadian people there will be a sufficient number of doctors graduated to meet, not

June 20, 1978

Adjournment Debate

only the present medical care level, but also the increasing care level of an aging population which requires more geriatricians all the time. Those 60 years of age and older require three times as much health care as they did at 35 years. Added to that is the earlier increase in cardiovascular disease, cancer, diabetes and other medical problems. Thus more physicians are required.

1 would also like to ask the minister how she expects to keep up the quality of medical care when among those leaving are well-trained professional men, such as teachers and scientists in whom millions of Canadian dollars have been invested in training. Now this knowledge and experience is going south of the border to be an asset there. Many leave with at least two or three decades of earning power before them. That is a prospective $3 million or $5 million, depending on their training. Taking the middle figure of $4 million and taking the minister's figure of 650 doctors emigrating-instead of my own which is much higher-it means that we are giving about $2.6 billion to the United States every year.

Canada simply cannot afford to present those billions of dollars to the United States even though that country is our friend. We do not have the money to enable us to play Santa Claus. Each one of those doctors has cost us between a quarter of a million dollars and half a million dollars, depending upon whether they are trained as general practitioners, have received special training or have gone into scientific research.

There will be a need in Canada for more physicians. According to my information and also that of the minister, there will be no increase in the numbers of doctors graduating even though more will be required. We have now passed the two million mark of those 60 years and over, according to the last figures available in 1976.

The minister has made a statement to the effect that Canada might have too many physicians. That is not correct as the figures include specialist physicians, doctors working in public service, working privately as administrators or for insurance companies, et cetera. Some work part-time. The general practitioner would not average 50 per cent of those, and in actual practice the GP should account for 60 per cent to 70 per cent of physicians. Ruling out part-time physicians, we have one general practitioner for roughly every 2,000 people.

The minister has also stated that the majority of those doctors emigrating were not Canadians. Surely she knows that in January 1977 the United States was asking for and admitting Canadian born doctors and that in the last three years there has been an increase of 300 per cent in those emigrating.

The problem is frightening in that our health care system may break down. It was a Liberal government that brought in the national health program, but over the years it has been using its child like an illegitimate or orphan child. It starves it of research, driving thousands of our young scientists outside the country.

The minister knew the tax position of the doctors. She was well aware that a doctor could not deduct the interest on a

bank loan on this tax return. He could not deduct the cost of mechanical equipment he needed to increase his knowledge, even though it increased his earning power, and as a result of that the government took increased taxes. The minister knew all this because of her previous portfolio as minister of national revenue.

No Canadian born doctor wants to pull up his roots and leave his home and friends. But because of the bureaucracy- the forms that take a quarter of his time to fill in, the wrangling with the bureaucrats of medicine and, finally, the high taxes and frustration, he leaves.

The minister must face those facts. There is a deterioration in the quality of medical service due to the loss of professors and researchers who trained the doctors. There is attrition and the increased service demands of an aging population. There is a breakdown of medical service because of the shortage of doctors, and this is compounded by the increasing number of people over 60 years of age who require service. These days people aged 50 are regarded as being in the geriatric class, and 1 would remind hon. members of this.

Mr. P. B. Rvnard (Simcoe North):

Mr. Speaker, I would like to address a question to the Minister of National Health and Welfare. In view of the loss of almost 4,000 doctors from Canada during the years 1967 to 1977, and with increasing losses now, what plans does the minister have to rectify this situation? Can she assure the public that there will be enough graduates coming along, not to guarantee the quality of care, because you cannot guarantee the quality of care when the top men are lost, but to guarantee that there will by physicians available to look after the increasing number of geriatric patients in the next ten years?

Mr. Rynard:

Mr. Speaker, in view of the fact that the bloc system runs for a period of five years, how can the minister be assured, when that program can be interrupted at any time within five years, that the quality of care and availability of doctors will be present in each and every province?

Mr. P. B. Rynard (Simcoe North):

Mr. Speaker, the hon. member for Vancouver Centre (Mr. Basford) referred in his remarks to the hon. member for Simcoe North. I am the hon. member for Simcoe North and, if I heard correctly, that reference to the hon. member for Simcoe North is on the record. I am not insulted by the reference but I do want the record corrected. The minister did refer to Simcoe North and it will appear that way in the record. I want it corrected, Mr. Speaker.

Mr. P. B. Rvnard (Simcoe North):

Mr. Speaker, I have asked the Minister of Communications (Mrs. Sauve) on two occasions to provide aid to assist persons afflicted with deafness. There are two million such in Canada. First of all, every Canadian has a right, regardless of this handicap, to an education which will allow that individual to develop and function to the maximum of his or her ability. The government has not seriously considered the needs and the welfare of the deaf. Employment of anyone handicapped rarely occurs unless there is some incentive. Manpower offers some assistance but the response is poor.

Very little money is spent on the deaf compared to what is spent on people with visible disabilities. The working deaf are taxpayers but they work in a world where, if not handicapped by the actual job, they are certainly handicapped by their surroundings which are altogether different from those of other people. They have little or no means of oral education, of hearing the conversation of others or of patronizing the things others do and getting news as you and I get it, Mr. Speaker, even though they have the same intelligence as we have. All this is beyond their means without special teachers. They do not yet have equal job opportunities and our twentieth century society does little to help them.

There are some questions that I should like to put to the parliamentary secretary who is representing the minister tonight. For instance, what education do the deaf get? Are they eligible for the $1,000 tax deduction that is available to other handicapped persons? It is rarely that we see these people rise to the level of university teaching, medicine or the other professions that are high on the pay scale. The George Brown college in Toronto draws a lot of people from all across the country and produces brilliant deaf scholars-many as brilliant as you would find here, Mr. Speaker, and maybe a little more brilliant at times. There is also a fine building for the deaf in Toronto which is being completed by the great war veteran, Con Smyth. I know him and the Reverend Roy Rumbull, Ernie Watts, and others I am not going to mention but who are also very interested in this work.

When I put my original question the minister told me that they are "researching". What are they researching, Mr. Speaker? They already have the decoder so why have they stopped? She said it costs $2,000 but I say let us spend the money. This device has been perfected and is working in the United States. Have funds been made available to Bell North-

May 16, 1978

ern Research, for instance, to go south of the border and research this system?

The decoder may be a bargain at $2,000 because it gives deaf people a chance to hear the things the rest of us hear. What more right have I, who can hear and see, to view the televised proceedings of parliament which is paid for by the taxpayers of this country, some of whom are deaf? Why can this decoder not be used so that they too can follow the proceedings? Are they not entitled to hear the hockey game that is being broadcast tonight? We are shutting these people out of many things because they are a quiet minority, and I say we have to do something about it.

Deaf people are often very innovative. Some of them took the old CN and CP teletype machines and converted them so that they could be used with the telephone. When you punch the keys a light comes on at the number you have dialed, the person there picks up the receiver and they can communicate back and forth. Why are we not pursuing this and getting ahead of the United States, instead of just waiting to copy them as we usually do?

I want to point out to the parliamentary secretary that it costs about $1 million to institutionalize a deaf person for 30 or 40 years. Yet they say the decoder only costs $2,000. Then when the unemployment rate goes up because it is hard for those persons who are a little hard of hearing to get a job, they look at them and say "no". I am not taking anything away from the government or manpower, because I know what they try to do, but look at what has been the response. Hon. members know the response as well as I do: it has been terrible. They just do not get it in this workaday world.

I want to go on a little further to say that there must be ideas and creative work for these people so long forgotten by the public purse which has poured out money on so many things that were far less deserving. Will the minister make a commitment to do something? Will she give some research funds to Bell Northern Research to make sure that the required research is done, and will she check with those in the United States? Will this invisible handicap then become one that will partially disappear?

In closing, I want to say to the parliamentary secretary for goodness sake let us stop putting things off and making excuses. Excuses only last so long. These are people who cannot speak for themselves or who cannot hear all that is going on. They are handicapped people that we all owe something to. As far as possible they try to work and do the things that they can do.