Canada has faced prolonged issues with access to family doctors and nurse practitioners.
During the morning commute, CTV News met Jhanvi Joshi on King Street in Fredericton, N.B. The 24-year-old moved to New Brunswick five years ago to study and said for the past two years, she’s been on a waiting list.
“It can be a little inconvenient sometimes. There’s some of the new online services where you can get a consultation, that’s definitely helped, but it would be nice to have a family doctor for sure,” said Joshi.
It’s estimated more than 6.5 million Canadians don’t have a primary care provider. According to the Canadian Medical Association, wait times are increasing and there are record-high emergency department closures.
Health care hasn’t dominated the federal campaign the way trade or the economy has, but it has come up in recent announcements and as parties shared their platforms.
While health care largely falls to the provinces, Ottawa plays a key role in its funding, setting and administering national standards through the Canada Health Act. The federal government also provides health care directly to groups such as Indigenous communities and members of the Canadian Armed Forces.
Dr. Joss Reimer, President of the Canadian Medical Association (CMA), told CTV News it’s appropriate that the economy is one of the top focuses of the federal election but highlights that health and economy are deeply interlinked.
“We know we have gaps in our system, and we know that in order for us to contribute to the economy, to fight back against what we’re facing with the U.S. and the global situation, we need our health,” said Reimer.
A Health Canada report released earlier this year found Canada is short 22,823 family doctors.
Dr. Reimer said there’s a need for a lot of solutions at the same time.
“Doing team-based care, reducing administrative burden, making sure that our systems talk to each other, all of these have to happen at the same time as we bring in international medical graduates,” she said.
According to the CMA, there’s been a surge in interest in an online portal for Canadian and international medical graduates that facilitates first steps of getting a medical license.
As more American doctors eye moving to Canada, the CMA is urging quick action to attract them by streamlining the immigration and licensing process.
“This is an opportunity we haven’t had in many years, and we really need to leverage it,” she said.
According to a Health Canada report, the country also has a gap of about 14,000 licensed practical nurses, 2,700 nurse practitioners and 28,000 registered nurses.
The Canadian Nurses Association (CNA) wants to see nurses fully optimized in their role. CNA also wants to see a streamlined approach to recruiting internationally trained nurses and a national licensure framework to make it easier for nurses to work across provinces.
“During this geopolitical crisis and economic environment, we need to make sure that we can leverage and optimize our nurses in whatever jurisdiction needs them,” CEO of Canadian Nurses Association Valerie Grdisa told CTV News.
When it comes to optimizing nurses, CNA highlights how nurse practitioners can be better utilized to provide primary care, and registered nurses could be used to prescribe medications.
“Our prescribing is utilized in rural, remote and northern and indigenous communities. And if it’s good enough for those populations, it’s good for all Canadians,” she said.
Nurse practitioners are registered nurses with additional education and experience that allows them to diagnose and treat illness and prescribe medications.
Grdisa believes Canada has been slow to optimize this role.
“We have to sort of stop this inertia around fully optimizing our highly educated, highly qualified, and incredible Canadian health workforce,” she said.
What have parties promised?
Liberals
The Liberals promise to add thousands of new doctors, build and expand medical schools and residency spots, and streamline credential recognition of internationally-trained doctors and nurses.
The party’s platform also commits to implementing a national licensure so doctors and nurses can easily work in different provinces and territories.
Liberal leader Mark Carney pledged to spend $4 billion to build and renovate hospitals and clinics and increase access to team-based care.
The Liberal Party has promised to expand eligibility for dental care to people aged 18 to 64, and keep what’s in place for pharmacare — coverage for birth control and diabetes medications.
Their platform commits to improving mental health care, including spending half a billion dollars in the Emergency Treatment Fund to deal with the overdose crisis.
Liberals also vow to make the Sexual and Reproductive Health Fund permanent — which includes guaranteeing funding for abortion care in Canada — and bringing in a new in vitro fertilization (IVF) program.
Conservatives
The Conservatives promise to add 15,000 doctors by 2030.
They vow to quickly recognize U.S.-certified professionals and expand residency spots for Canadians studying medicine abroad.
A Poilievre-led government would launch a Blue Seal Program to license doctors and nurses who prove they’re qualified through a test and work with provinces to make a nationally-recognized license for doctors, nurses, childcare workers and other professions so they can work across provinces.
The Conservatives say they will honour all health transfer agreements with provinces and will maintain existing federal dental-care, pharmacare and child-care programs.
The party also pledged to defund safe supply programs and sue opioid manufacturers. A Conservative-led government would spend $1 billion over four years to fund recovery treatment for 50,000 people dealing with addiction. Funding would be tied to the length of time patients stay drug-free.
The Conservatives would maintain access to medical assistance in dying, but won’t expand it to include advance directives.
The party has promised a Conservative government would not bring in any laws or rules to restrict or regulate abortion.
NDP
The NDP promises to ensure all Canadians have access to a family doctor by 2030 by incentivizing provinces with an additional one per cent in Canada Health Transfer funding if they commit to action and publicly report on progress.
The party pledges to make it easier for U.S. doctors to come to Canada, create residencies for qualified, internationally trained doctors already living in Canada and also implement a pan-Canadian licensure so doctors and nurses can work nationwide.
NDP Leader Jagmeet Singh also promised to hire 35,000 nurses by 2030.
An NDP government would establish a complete public pharmacare system within four years, starting with an expansion with “100 of the most prescribed medications,” including pain medications and antibiotics.
The NDP has also pledged to crack down on “cash-for-care” clinics that charge Canadians for basic services and to ban American firms from buying up Canadian health-care assets.
The party promises to improve mental health care with a new program to cover counselling and psychotherapy for Canadians not covered by work plans and expand funding for crisis and addictions care.
What do some provinces want?
New Brunswick’s Premier Susan Holt won her province’s election on a promise to prioritize and open 30 new collaborative care clinics.
“New Brunswickers made it clear that their number one priority is improved access to health care close to home when they need it,” Holt said.
Recently, the Holt government announced the opening of collaborative care clinics to attach some of the 180,000 New Brunswickers who are without a primary care provider to a health team.
“We’re looking for a transformation of our primary care system,” Holt said, adding they’re also wanting to modernize health information so it’s accessible to providers at any point.
Through the Canada Health Transfer, Ottawa will send more than $52 billion dollars to the provinces this year — $1.1 billion of which will go to New Brunswick.
“We could always use more. The cost of delivering health care is getting more and more expensive, and we need to remain competitive,” said Holt.
