'This is a crisis': Head of medical association warns that the health-care system faces 'collapse'

The new president of the Canadian Medical Association (CMA) said Wednesday he fears the country's fragile health-care system will deteriorate further without an injection of cash — and a plan to increase the number of doctors and other health care professionals.

Incoming CMA president calls for 'pan-national licensure' to make licensing doctors easier

A sign indicates the estimated wait time at Humber River Hospital's emergency department in Toronto on April 26. The hospital is facing higher patient volumes and a rise in flu cases. (Alex Lupul/CBC)

The new president of the Canadian Medical Association (CMA) said Wednesday he fears the country's fragile health-care system will deteriorate further without an injection of cash — and a plan to increase the number of doctors and other health care professionals.

Dr. Alika Lafontaine, an anesthesiologist in Grande Prairie, Alta., and the group's first Indigenous president, told CBC News that Canada's health care is in "dire" straits, with quality care severely limited in some parts of the country.

He pointed to recent emergency room closures in Ottawasouthwestern Ontario, Quebec and other locales and eye-popping ER wait times in major cities like Toronto and Montreal as terrible precedents undermining the longstanding Canadian promise of timely access to care for all who need it.

"We've been saying for a while that we're concerned about collapse. And in some places, collapse has already happened," Lafontaine said.

A man wearing a suit and patterned tie stands, smiling, in front of a building.
Dr. Alika Lafontaine, the new president of the Canadian Medical Association (CMA), was born and raised in Treaty 4 Territory in Saskatchewan. (Canadian Medical Association)

"All of these things are not normal things for Canadians to experience so we are at a critical point right now. If you can't access services, that literally does mean collapse."

Doctors on the frontlines are at a breaking point and have been for the better part of two-and-a-half years, he said.

"We're all trained to deal with acuity. We're all trained to deal with critical situations. But what's happening now goes far beyond anything we've experienced before," Lafontaine said.

Lafontaine's comments came after the CMA released a new report Thursday warning that all provincial and territorial systems are grappling with similar problems — especially staffing.

The problem is essentially one of human resources, he said, and there are not enough doctors and nurses available to staff existing facilities, let alone serve a growing population.

One of Lafontaine's proposed solutions is to introduce what he calls "pan-national licensure," which would allow physicians to work across the country with fewer regulatory burdens.

This sort of portability would give doctors more flexibility to practise where they're needed most. It could also make it easier for foreign-trained doctors to move about the country.

He said the current system — in which each province has its own licensing system — is a barrier.

A nationwide 'human resources plan' for health care

A national physician licence could provide a single, streamlined process for verifying the credentials of internationally trained doctors, he said.

"We need to rethink the idea that we can carry on with 13 separate health systems that don't collaborate with each other at a really deep level," he said.

He said the federal government must convene a meeting with provincial and territorial governments to develop some sort of "health human resources plan" to address staffing gaps and other pressing issues.

Beyond playing some sort of coordinating role, Lafontaine said, Ottawa should also pump more money into the system.

"We definitely do need more resources in the system to move forward. But what's important is where those resources go," he said, adding past federal efforts to specifically earmark money for mental health or homecare for the elderly have been successful.

Federal Health Minister Jean-Yves Duclos has suggested more money will flow to provincial coffers in the coming months — but he has said it won't be a blank cheque.

Duclos already has laid out Ottawa's top five priorities for new health-care spending: an end to service backlogs, an increase in the number of health-care workers, improved access to primary care, a better system of long-term care and home care for seniors, more resources for mental health and substance abuse, and a renewed push to digitize health data and facilitate more virtual care.

The issue of cumbersome licensing for doctors trained outside the country has come to a head recently in several provinces.

Last month, Ontario Health Minister Sylvia Jones directed the province's regulatory colleges to develop plans to more quickly register internationally educated doctors and nurses.

Other provinces, including Nova Scotia and Newfoundland and Labrador, are working to streamline their procedures as they welcome Ukrainian doctors fleeing the war in their country.


John Paul Tasker

Senior reporter

J.P. Tasker is a journalist in CBC's parliamentary bureau who reports for digital, radio and television. He is also a regular panellist on CBC News Network's Power & Politics. He covers the Conservative Party, Canada-U.S. relations, Crown-Indigenous affairs, climate change, health policy and the Senate. You can send story ideas and tips to J.P. at john.tasker@cbc.ca.

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