Senate committee conclusions | Report largely ignores changes in rural health-care delivery
A Senate committee report has concluded that the billions of dollars committed by Ottawa in 2004 to “fix health care for a generation” has fallen short of its goal.
The expensive 10-year commitment by then Liberal prime minister Paul Martin has not produced the “transformative change” in health-care delivery that was promised.
However, the report largely ignored a major area of the failure — the lack of significant change in rural health-care delivery.
The report from the Senate social affairs, science and technology committee did recommend that Ottawa and the provinces work with the health-care system “to reduce inequities in health human resources such as rural and remote health care, vulnerable communities and aboriginal communities.”
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That was the main reference to rural health care in the 91-page report, although there was major emphasis on northern and aboriginal issues.
Quebec doctor John Wotton, president of the Society of Rural Physicians of Canada, said the Senate report did not recognize the lack of progress in closing the rural-urban gap in health care, although he supported the recommendation to concentrate on health-care worker numbers in rural areas.
“Except for some nibbling at the problem from the edges, there hasn’t been a substantial amount of improvement,” Wotton said.
Medical graduates still generally do not head to rural areas to practice, and the trend to specialized medicine is making it worse because rural areas need general practitioners.
The federal government announced several budgets ago that beginning this year, medical graduates and nurses willing to work in rural areas would see forgiveness of some of their accumulated student loans.
Wotton said a glitch in the program is that students must begin paying off their loans when they graduate, even though they do three years of residency, typically at urban hospitals, before they begin to practice.
“It means that by the time they are ready to set up practice, they already have paid a chunk of their debt and that reduces the incentive to go to the rural,” he said. “It really is a structural problem in the program.”
He said rural residents continue to have unequal access to the health-care system, much of it the result of the tendency of health-care personnel to work in urban areas where amenities and compensation can be greater.
