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
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.
Topic: PROCEEDINGS ON ADJOURNMENT MOTION
Subtopic: HEALTH AND WELFARE-EMIGRATION OF DOCTORS FROM CANADA